| Objective:To retrospectively analyze the case data of premature infants in neonatology department of the First Affiliated Hospital of Nanchang University,to explore the risk factors related to preterm birth and the characteristics of common complications in premature infants,and to provide epidemiological data for reducing premature birth rate and improving the prognosis of premature infants.Methods:The data of premature infants born in the First Affiliated Hospital of Nanchang University from December1,2016 to May 31,2018 were collected and retrospectively analyzed.SPSS22.0 statistical software was used to process the data.and the data were compared by X2 test.The relationship between risk factors and premature birth was analyzed by logistic regression.The main risk factors leading to premature delivery,complications of preterm infants and hearing screening results were screened out.?=0.05 as the test level,P <0.05,indicating that the difference is statistically significant,to explore the risk factors for preterm birth,analysis of common complications in premature infants,to provide a scientific basis for prevention and treatment of preterm birth and improve the long-term quality of life of premature infants.Results:From December 1,2016 to May 31,2018,the Department of Neonatology in our hospital received 667 preterm infants,accounting for 40.62% of the total number of hospitalized neonates in the same period(the total number of 1,642 patients,including 975 full-term children).The details are as follows:1.Grouping situation:According to birth weight Grouping:59 cases of very low birth weight reorganization(860g~<1500g);361cases of low birth weight recombination(1500g ~ ? 2500g);247 cases of normal birth body reorganization(>2500g);according to gestational age group: 21 cases of gestational age(28~<30weeks)group;194 cases of gestational age(30~?34 weeks)group;452 cases of gestational age(>34~<37 weeks)group;group according to the degree of asphyxia:538 patients in the normal group,Apgar score in 1 minute(8-10 points);101 patients in the mild asphyxia group,Apgar score in 1 minute(4-7 points);18 patients in the severe asphyxia group,1 minute Apgar score(0-3 points);Apgar scores of 10 premature infants 1 minute after birth are unknown;2.The main risk factors leading to premature birth:(1)The combined diseases of pregnant mothers during pregnancy were: 63 cases(9.45%)of gestational diabetes,55 cases(8.25%)of gestational hypertension,52cases(7.80%)of eclampsia,cholestasis syndrome during pregnancy 47 cases(7.05%)and 46 cases of hepatitis B(6.90%).(2)Fetal abnormal factors were more common in 126 cases of premature rupture of membranes(18.89%),110 cases of twin pregnancy(16.49%),and 58 cases of intrauterine distress(8.70%).(3)The abnormalities of amniotic fluid,umbilical cord and placenta were as follows: 89 cases of amniotic fluid abnormality(13.35%),62 cases of placental abnormality(9.30%),and 19 cases of umbilical cord abnormality(2.85%).Through logistic regression analysis of high-risk factors,it was found that twin pregnancy,premature rupture of membranes,placenta previa,amniotic fluid contamination,intrauterine distress,and pregnancy complications include(diabetes,hypertension,eclampsia,cholestasis),thyroid dysfunction,acute abdomen,thrombocytopenia,kidney disease,etc.are all risk factors for preterm birth,P <0.05,the difference was statistically significant.3.The complications of premature infants were: respiratory distress syndrome in201 cases(30.13%),anemia in 164 cases(24.59%),neonatal asphyxia in 119 cases(17.84%),respiratory failure in 66 cases(9.90%),apnea 62 cases(9.3%),coagulopathy(7.5%),gastrointestinal bleeding(7.20%),pneumonia(6.75%),premature infant encephalopathy(6.60%),metabolic acidosis(5.10%),electrolyte metabolism disorder(5.10%),hyperbilirubinemia(4.20%),neonatal cold injury syndrome(3.45%),neonatal hypoxic ischemic encephalopathy(3.15%),feedingintolerance(2.25%),intracranial hemorrhage(1.95%)),sepsis(1.95%),thrombocytopenia(1.8%),hypoglycemia(1.65%),abnormal liver function(1.5%),neonatal necrotizing enterocolitis(0.75%),hypotension(0.75%)Hyperglycemia(0.60%),pulmonary hemorrhage(0.45%),shock(0.45%),congenital malformation(2.7%);According to the statistical results,the smaller the gestational age and the lower the birth weight,the higher the probability of premature infants with respiratory distress syndrome,anemia,asphyxia,respiratory failure and apnea,P<0.05,the difference was statistically significant;4.The results of cardiac color Doppler ultrasound were abnormal in 196 cases(52.66%),patent foramen ovale(128 cases,30.92%)and patent ductus arteriosus(62cases,14.98%)are most common?5.A total of 616 premature infants who had improved hearing screening during hospitalization(screening rate 92.35%),using transient evoked otoacoustic emission test,the binaural pass rate was 60.55%,the binaural unpass rate was 23.38%,and the single ear failed rate was 16.77%;while the automatic hearing brainstem evoked potential test showed that the binaural pass rate was 26.30%,and the pass rate was significantly lower than that of the transient evoked otoacoustic emission method.The binaural failure rate was 55.36%,and the single ear failure rate was 18.34%.both ears passed 154 cases of two test methods,the pass rate was 25%,and the rate of failure was 75%.The pass rate of hearing screening in premature infants was low,and it was positively correlated with gestational age and birth weight,and negatively correlated with the degree of asphyxia,P<0.05,and the statistical difference was significant.6.There were 186 premature infants who underwent fundus screening during hospitalization,and 15 cases of ROP were found,accounting for 8.06%.Among them,8 cases(4.30%)had stage III and above ROP,and the smaller the gestational age,the lower the birth weight.the incidence of ROP is higher,especially the incidence of gestational age <30 weeks(11/21 cases)52.38%,and the incidence rate of birth weight <1500g(13/59 cases)22.03%.Conclusion:1.Multiple risk factors can lead to premature birth,including mother factors,fetal factors,amniotic fluid,placenta,umbilical cord abnormal factors,including twin pregnancy,premature rupture of membranes,placenta previa,amniotic fluid contamination,intrauterine distress and pregnancy Diabetes,hypertension,eclampsia,cholestasis,thyroid dysfunction,acute abdomen,thrombocytopenia,kidney disease,etc.are risk factors for preterm birth.2.Respiratory distress syndrome,anemia,asphyxia,respiratory failure,apnea,etc.are the most common complications of premature infants.The incidence is negatively correlated with gestational age and birth weight,the smaller the gestational age,the lower the birth weight.the higher the incidence of these complications.3.The pass rate of hearing screening in premature infants is low.The gestational age,birth weight and degree of asphyxia are the main factors affecting the rate of hearing screening.The smaller the gestational age,the lower the birth weight and the heavier the asphyxia,the lower the initial screening rate of hearing,and the pass rate of the automatic hearing brainstem evoked potential method is lower than that of the transient evoked otoacoustic emission method.4.Screening of the fundus in preterm infants during hospitalization is important,and early detection of retinopathy,especially in preterm infants with gestational age<30 weeks and birth weight <1500g,is high.5.The results of cardiac color Doppler ultrasound in premature infants were found to be high,and the patent foramen ovale and patent ductus arteriosus are the most common.In summary,premature infants have poor basic conditions and are prone to multiple diseases.Strengthening the management of high-risk pregnant women and premature infants is the key to avoiding premature birth,reducing morbidity and improving long-term quality of life. |
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