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目的:通过不同类型的重度子前期(severe preeclampsia,S-PE)早产和自发早产的对比分析,探讨影响S-PE早产结局的相关因素。方法:将重度子前期(研究组)早产72例(早产儿83例),按不同孕周分为早期早产、中型早产及轻型早产3类,分别与相同类型的自发早产(对照组)222例(早产儿279例)进行孕产妇及围生儿结局对比分析。结果:研究组及对照组3类型间的早产儿病死率差异有显著性(P=0.000)。研究组与对照组同类型间早产儿病死率比较,差异无显著性(P>0.05);研究组早期早产儿平均出生体重明显低于对照组(P=0.003),而早产儿并发症发生率与对照组比较,差异无显著性(P>0.05);研究组中的中型早产新生儿除重度窒息明显高于对照组外(P=0.022),新生儿平均出生体重、新生儿轻度窒息率、新生儿病死率及新生儿加强护理NICU(neonatel intensive care unit,NICU)住院日和住院费两组间差异无显著性;在轻型早产组,除研究组NICU住院日明显长于对照组外(P=0.000),两组间其他观察指标的差异均无显著性。多元回归分析显示,早产的分娩孕龄是影响重度子前期早产儿死亡的主要因素;促胎肺成熟和孕期检查是影响新生儿病率的主要因素。结论:不论重度子前期早产还是自发早产,在早期早产阶段影响围生儿预后的主要因素是分娩孕龄,重度子前期早产与自发早产围生结局无明显差异。
OBJECTIVE: To explore the factors influencing the outcome of S-PE premature delivery through the comparative analysis of different types of severe preeclampsia (S-PE) premature delivery and spontaneous preterm delivery. Methods: Seventy two premature children (83 preterm infants) were divided into three groups: early preterm labor, moderate preterm labor and light preterm labor according to different gestations. 222 preterm infants with the same type of spontaneous preterm birth (control group) (279 cases of premature children) maternal and perinatal outcomes comparison analysis. Results: There was a significant difference in the mortality rate of preterm children between study group and control group (P = 0.000). There was no significant difference in the mortality of preterm infants between the study group and the control group (P> 0.05). The average birth weight of the early preterm infants in the study group was significantly lower than that of the control group (P = 0.003) Compared with the control group, the difference was insignificant (P> 0.05). The median preterm newborns in the study group were significantly higher than those in the control group except for severe asphyxia (P = 0.022) , Neonate mortality and neonatel intensive care unit (NICU) hospitalization days and hospitalization costs were no significant difference between the two groups; in the light preterm group, in addition to study group NICU length of stay was significantly longer than the control group (P = 0.000), there was no significant difference between the other two groups. Multivariate regression analysis showed that the gestational age of preterm delivery was the main factor affecting the death of premature children with severe preeclampsia; the promotion of fetal lung maturity and pregnancy test were the main factors affecting neonatal morbidity. Conclusion: Whether severe preterm premature delivery or spontaneous premature delivery, the main factors influencing the prognosis of perinatal infants in early preterm delivery stage are gestational gestational age, no significant difference in perinatal outcome between premature preterm and spontaneous preterm birth.