ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2022, Vol. 14 ›› Issue (6): 508-512.doi: 10.3969/j.issn.1674-3865.2022.06.011

• 临床研究 • 上一篇    下一篇

双胎妊娠新生儿呼吸窘迫综合征的高危因素

尹雪, 易海英, 甘斌, 杨树杰, 尹娜娜, 姚化军, 张海娥   

  1. 121001 辽宁 锦州，锦州医科大学武汉科技大学附属孝感医院研究生培养基地（尹雪，姚化军，张海娥）；432100 武汉，武汉科技大学附属孝感医院新生儿科（易海英，甘斌，杨树杰）；056500 河北 邯郸，河北省磁县妇幼保健院产后保健科（尹娜娜）

  • 收稿日期:2022-05-25 出版日期:2022-12-25 上线日期:2022-12-25
  • 通讯作者: 易海英，E-mail：13797149196@163com
  • 基金资助:
    湖北省儿科联盟医学科研项目（HPAMRP202113）

High risk factors of neonatal respiratory distress syndrome in twin pregnancy

YIN Xue, YI Haiying, GAN Bin, YANG Shujie, YIN Nana, YAO Huajun, ZHANG Hai′e   

  1. Postgraduate Training Base of Xiaogan Hospital affiliated to Wuhan University of Science and Technology,Jinzhou Medical University,Jinzhou 121001,China

  • Received:2022-05-25 Published:2022-12-25 Online:2022-12-25
  • Contact: YI Haiying，E-mail：13797149196@163com

PDF (PC)

15

摘要： 目的 探讨双胎妊娠新生儿呼吸窘迫综合征（NRDS）发生情况及其危险因素。方法 回顾性分析2017年1月至2021年12月在武汉科技大学附属孝感医院新生儿科的住院的222对（444例）活产双胎新生儿的临床资料，其中双胎儿均患NRDS 51对（102例），双胎之一患NRDS39对（78例），双胎儿均未患NRDS132对（264例），比较三组新生儿一般资料及NRDS发生情况。 结果 （1）单因素分析显示，双胎儿均患NRDS组、双胎之一患NRDS组与双胎儿均非NRDS组在胎龄及出生体质量差异有统计学意义（P<0001）。双胎儿均患NRDS组、双胎之一患NRDS组与双胎儿均非NRDS组在产前皮质激素使用差异有统计学意义（P<0001）。双胎儿均非NRDS组与双胎儿均NRDS组、双胎之一患NRDS组在1 min Apgar评分≤7分比例差异有统计学意义（P<0001）。（2）以双胎均未发生NRDS作为参照组，纳入胎龄、出生体质量、产前皮质激素等构建多因素Logistic回归方程。结果发现，胎龄小、1 min Apgar评分≤7分、产前未使用皮质激素双胎及双胎之一更容易均患NRDS。 结论 胎龄小、产前未使用皮质激素、1 min Apgar评分≤7分的双胎新生儿更容易发生NRDS，双胎之间患NRDS存在差异，与胎龄、1 min Apgar评分≤7分有关，故产前需规范地使用皮质激素，预防窒息，选择合适的分娩时机与分娩方式，减少NRDS的发生。


关键词: 新生儿呼吸窘迫综合征, 双胎, 危险因素

Abstract: Objective To investigate the incidence and risk factors of neonatal respiratory distress syndrome（NRDS） in twin pregnancy. Methods The clinical data of 222 pairs（444 cases） of live twin newborns hospitalized in the Department of Neonatology of Xiaogan Hospital Affiliated to Wuhan University of Science and Technology from January 2017 to December 2021 were analyzed retrospectively，including 51 pairs of twins（102 cases）(both with NRDS)(group A)，39 pairs of twins（78 cases）(one with NRDS)(group B ) and 132 pairs of twins（264 cases）(without NRDS)(group C).The general data of newborns and the incidence of NRDS in the three groups were compared. Results (1) Univariate analysis showed that there were significant differences in gestational age and birth weight between group A/group B and group C(P<0.001). There was a statistically significant difference in prenatal corticosteroid use between group A/group B and group C(P<0.001). The ratio of Apgar score ≤7 in 1 min between group A/group B and group C was statistically significant(P<0.001).（2）Taking group C as the control group，the gestational age，birth weight and prenatal corticosteroids use were included to construct a multivariate logistic regression equation. The results showed that twins with small gestational age，1 min Apgar score ≤7 and no prenatal use of corticosteroids were more likely to suffer from NRDS.Conclusion Twins with small gestational age，no prenatal use of corticosteroids and 1 min Apgar score ≤7 are more likely to develop NRDS. There are differences in NRDS between twins，which is related to gestational age and 1 min Apgar score ≤7.Therefore，prenatal use of corticosteroids should be standardized to prevent asphyxia;select appropriate delivery time and mode，to reduce the occurrence of NRDS.Conclusion Twins with small gestational age，no prenatal use of corticosteroids and 1 min Apgar score ≤ 7 are more likely to develop NRDS.There are differences in NRDS between twins，which is related to gestational age and 1 min Apgar score ≤7.Therefore，prenatal use of corticosteroids should be standardized to prevent asphyxia，select appropriate delivery time and mode，and reduce the occurrence of NRDS.


Key words:

Neonatal respiratory distress syndrome, Twins, Risk factors