Retrospective Analysis Of Risk Factors For Multiple Organ Damage After Neonatal Asphyxia

Objective: To investigate the risk factors of multiple organ damage after neonatal asphyxia,and to provide reference for prevention and treatment of multiple organ damage after neonatal asphyxia.Methods: A total of 282 newborns with asphyxia admitted to the neonatal ward of chengdu and shenzhen hospitals from January 2014 to April 2019 were screened by case-control method based on inclusion and exclusion criteria.According to whether multi-organ damage occurred,the patients were divided into the case group(n=130)and the control group(n=152).In accordance with relevant regulations,the general situation of newborns [sex,gestational age(AG),birth weight(BW),fetal number,umbilical cord,amniotic fluid,fetal intrauterine growth,degree of asphyxia],maternal pregnancy related conditions [age,previous stillbirth history,anemia during pregnancy,thyroid disease,intrahepatic cholestasis of pregnancy(ICP),gestational diabetes mellitus(GDM),gestational hypertension(GH),preeclampsia(PE)] and birth-related conditions [delivery mode,vaginal delivery,rapid delivery,prolonged second stage of labor,general anesthesia of the mother,fetal distress(FD),abnormal fetal position,placenta previa,placental aging,placental abruption,premature rupture of membranes(PROM)] of the two groups were collected,and the basic data analysis and the single factor analysis were conducted respectively.The influential factors with statistical significance in single factor analysis were taken as independent variables into the regression model for multivariate unconditional logistic regression analysis,and the risk factors of multiple organ damage after neonatal asphyxia were obtained.Results:(1)Among the 282 newborns with asphyxia,130(46.10%)were in the case group and 152(53.90%)were in the control group.In the case group,113 cases(86.92%)had brain damage,110 cases(84.62%)had heart damage,69 cases(53.08%)had lung damage,46 cases(35.38%)had kidney damage,28 cases(21.54%)had liver damage,and21 cases(16.15%)had gastrointestinal damage.In the control group,68 cases(44.74%)had no organ damage,40 cases(26.32%)had brain damage,16 cases(10.53%)had heart damage,14 cases(9.21%)had lung damage,8 cases(5.26%)had gastrointestinal damage,3 cases(1.97%)had kidney damage,and 3 cases(1.97%)had liver damage.(2)The incidence of multiple organ damage in severe asphyxia group was higher than that in mild asphyxia group,and the difference was statistically significant(P<0.05).The incidence of brain,heart,lung,kidney,liver and gastrointestinal organs injury in severe asphyxia group was higher than that in mild asphyxia group,and the difference was statistically significant(P<0.05).(3)The results of single factor analysis showed that eight influencing factors including preterm delivery,low birth weight,umbilical cord abnormality,severe asphyxia,prolonged second stage of labor,fetal distress,fetal position abnormality and premature rupture of membranes were compared between the two groups,and the differences were statistically significant(P<0.05).(4)the results of multivariate analysis showed that severe asphyxia(P<0.05,OR=6.511),fetal distress(P<0.05,OR=4.114),premature delivery(P<0.05,OR=2.577)and umbilical cord abnormality(P<0.05,OR=2.513)were the risk factors for multiple organ damage after neonatal asphyxia.Conclusion: Severe asphyxia,fetal distress,premature delivery and umbilical cord abnormality are the risk factors for multiple organ damage after neonatal asphyxia.