314例医源性早产临床分析

Clinical analysis of 314 cases with iatrogenic preterm birth

关键词:  医源性早产  病因  早产儿  预后

Key words:  iatrogenic preterm labor  cause  premature infants  prognosis

摘要:

目的　研究医源性早产的高危因素及发生率，探讨不同孕周对早产儿预后的影响。　方法　回顾性分析2009年1月至2014年12月哈尔滨市第一医院收治的314例医源性早产病例的临床资料，对发生率、相关发生因素等进行分析。　结果　医源性早产发生率为6.76%，占早产总数的31.06%，医源性早产的发生率呈上升趋势。医源性早产的发生因素分别为妊娠期高血压疾病，胎盘因素性出血，双胎妊娠，子宫因素，胎儿因素及产科合并症。分娩时间≥34周较＜34周并发症及围生儿死亡率均显著降低（P＜0.01）。　结论　医源性早产已成为早产的重要原因。为改善早产儿预后，产科医师应制定个体化治疗方案，适当延长孕周至34周及以后。

Abstract:

Objective　To investigate the causes, incidence of iatrogenic preterm birth and to compare the prognostic effect of different gestational age on preterm labor infants.　Methods　Totally 314 cases of iatrogenic preterm labor in Haerbin the First Hospital from January 2009 to December 2014 were retrospectively analyzed.Relevant information was used for statistical description and statistical analysis.　Results　From January 2009 to December 2014, the incidence of iatrogenic preterm birth was 6.76%, accounting for 31.06% of the total recorded preterm births.The incidence of iatrogenic preterm birth was increasing.The top three causes of the iatrogenic preterm birth were severe pre-eclampsia, placenta previa and multiple births.Human factor was an important cause.The prognosis of premature infants at different gestational age was significantly different with a better prognosis at delivery time ≥34 weeks than ＜34 weeks (P<0.01).　Conclusion　Iatrogenic preterm birth has become an important reason of preterm birth.To improve the prognosis of premature infants, obstetricians should choose individual treatment and prolong the gestational age as far as possible to 34 weeks.