晚期早产儿从子宫内到子宫外环境过渡的研究

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Abstract Objective To evaluate the risk factors of late preterm infants (LPIs), recovery and hypothermia of LPIs, and to explore the complications of transition of LPIs. Methods The retrospective cohort study was conducted on 268 LPIs delivered consecutively in Daxing Hospital Affiliated to Capital Medical University, and they were divided into three groups：60 cases of 34 weeks group, 75 cases of 35 weeks group and 133 cases of 36 weeks group, stratified by gestational age (GA). Maternal and neonatal data, recovery, temperature at birth(T1) and 2 hours after birth (T2) were analyzed among all groups. Results Seventy cases (26.1%) of LPIs were diagnosed pregnancy complications during pregnancy, and preeclampsia and intrahepatic cholestasis were significantly higher in the 34 weeks group than in the 35 weeks and 36 weeks groups (all P < 0.05). 47 cases (17.5%) of LPIs were diagnosed ventilation resuscitation, 36 cases (13.4%) needed oxygen resuscitation (mask or tracheal intubation), the ratio of oxygen resuscitation in 34 weeks group was significantly higher than that of the 35 weeks group and 36 weeks group, and the differences were statistically significant (P < 0.05). The differences in LPIs with different gestational age, and situation of prenatal steroid therapy, spontaneous preterm birth, cesarean section and preeclampsia of pregnant mother were statistically significant (P < 0.05). Fetal age was an independent risk factor for oxygen recovery of LPIs (P < 0.05). From T1 to T2, the ratio of normal body temperature of newborns in the 34 weeks group was significantly lower than that of the 35 weeks group and 36 weeks group, and incidence of LPIs respiratory diseases and NICU admission rate of 34 weeks group were significantly higher than those of 35 weeks group and 36 weeks group, and the differences were statistically significant (P < 0.05). Conclusion The lower the GA of LPIs is, especially at 34 gestational weeks, the more maternal complications, the greater the need for resuscitation in delivery room, the risk of hypothermia, the higher the rate of respiratory diseases and NICU admission and the greater the difficulty of the transition from intra to extra-uterine environment in late preterm infant are, and target management at birth is reeded.

Key words： Late preterm infant Transition Neonatal asphyxia resuscitation Thermoregulation Gestational diseases

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	XIE Lu ZHANG Zheng SUN Liping LIU Yuming DI Jianhui

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XIE Lu ZHANG Zheng SUN Liping LIU Yuming DI Jianhui. Research of the transition from intra to extra-uterine environment of late preterm infant[J]. 中国医药导报, 2018, 15(20): 74-78.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2018/V15/I20/74

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