目的 研究妊娠高血压综合征（妊高征）对极低出生体重早产儿并发症的影响。方法 收集极低出生体重早产儿作为研究对象，根据母亲是否患有妊高征分为两组，比较两组患儿主要并发症发生率及住院时间。结果 （1）两组患儿间胎龄、出生体重、性别、母亲糖尿病发生率、产前激素使用率的差异均无统计学意义，妊高征组SGA发生率明显高于非妊高征组。（2）妊高征组支气管肺发育不良（BPD）发生率明显低于非妊高征组，而早产儿呼吸暂停（AOP）、坏死性小肠结肠炎（NEC）、早产儿视网膜病变（ROP）、早产儿颅内出血-脑白质病变（IVH-PVL）发生率及住院天数的差异均无统计学意义。（3）两组间NRDS发生率无差异，但妊高征组NRDS患儿PS使用率明显低于非妊高征组。结论 妊高征可减轻早产儿呼吸系统并发症，降低PS使用率，减少BPD发生率。
Abstract
Objective To study the effect of pregnancy-induced hypertension syndrome (PIH) on complications in very low birth weight (VLBW) preterm infants. Methods The VLBW preterm infants were enrolled as research subjects, and according to the presence or absence of PIH in their mothers, they were divided into PIH group and non-PIH group. The incidence of major complications and length of hospital stay were compared between the two groups. Results There were no significant differences between the two groups in gestational age, birth weight, sex, incidence rate of maternal diabetes, and use of antepartum hormone. The PIH group had a significantly higher rate of birth of small-for-gestational-age infants than the non-PIH group. The PIH group had a significantly lower incidence rate of bronchopulmonary dysplasia (BPD) than the non-PIH group, while there were no significant differences between the two groups in the incidence rates of apnea of prematurity, necrotizing enterocolitis, retinopathy of prematurity, and intraventricular hemorrhage-periventricular leukomalacia, and the length of hospital stay. There was no significant difference in the incidence rate of neonatal respiratory distress syndrome between the two groups, but the PIH group had a significantly lower proportion of infants who used pulmonary surfactant than the non-PIH group. Conclusions PIH can alleviate respiratory complications and reduce the use of pulmonary surfactant and the incidence rate of BPD in preterm infants.
关键词
妊高征 /
并发症 /
极低出生体重儿 /
早产儿
Key words
Pregnancy-induced hypertension syndrome /
Complication /
Very low birth weight infant /
Preterm infant
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参考文献
[1] 漆洪波, 石岩. 子癎前期及子癎的诊治进展[J]. 中华妇幼临床医学杂志(电子版), 2009, 5(1):2-4.
[2] Sibai BM. Preeclampsia as a cause of preterm and late preterm (near-term) births[J]. Semin Perinatol, 2006, 30(1):16-19.
[3] Cetinkaya M, Ozkan H, Koksal N. Maternal preeclampsia is associated with increased risk of necrotizing enterocolitis in preterm infants[J]. Early Hum Dev, 2012, 88(11):893-898.
[4] Gemmell L, Martin L, Murphy KE, et al. Hypertensive disorders of pregnancy and outcomes of preterm infants of 24 to 28 weeks'gestation[J]. J Perinatol, 2016, 36(12):1067-1072.
[5] 陈超. 新生儿呼吸窘迫综合征[M]//邵肖梅, 叶鸿瑁, 丘小汕. 实用新生儿学. 第4版. 北京:人民卫生出版社, 2014:395-398.
[6] Tubman TR, Rollins MD, Patterson C, et al. Increased incidence of respiratory distress syndrome in babies of hypertensive mothers[J]. Arch Dis Child, 1991, 66(1):52-54.
[7] Langenveld J, Ravelli AC, van Kaam AH, et al. Neonatal outcome of pregnancies complicated by hypertensive disorders between 34 and 37 weeks of gestation:a 7 year retrospective analysis of a national registry[J]. Am J Obstet Gynecol, 2011, 205(6):540.
[8] Yen TA, Yang HI, Hsieh WS, et al. Preeclampsia and the risk of bronchopulmonary dysplasia in VLBW infants:a population based study[J]. PLoS One, 2013, 8(9):e75168
[9] von Dadelszen P, Magee LA, Taylor EL, et al. Maternal hypertension and neonatal outcome among small for gestational age infants[J]. Obstet Gynecol, 2005, 106(2):335-339.
[10] 苗莹, 杨吉. 138例妊高征及围生儿结局分析[J]. 辽宁医学杂志, 2003, 17(4):194-195.
[11] Hansen AR, Barnés CM, Folkman J,et al. Maternal Preeclampsia Predicts the Development of Bronchopulmonary Dysplasia[J]. J Pediatr, 2010, 156(4):532-536.
[12] O'Shea JE, Davis PG, Doyle LW. Maternal preeclampsia and risk of bronchopulmonary dysplasia in preterm infants[J]. Pediatr Res, 2012, 71(2):210-214.
[13] Schlapbach LJ, Ersch J, Adams M, et al. Impact of chorioamnionitis and preeclampsia on neurodevelopmental outcome in preterm infants below 32 weeks gestational age[J]. Acta Paediatr, 2010, 99(10):1504-1509.
[14] Hentges CR, Silveira RC, Ferrelli RS, et al. Influence of maternal preeclampsia on VEGF/PlGF heterodimer levels in preterm infants[J]. J Matern Fetal Neonatal Med, 2015, 28(18):2166-2171.
[15] Abman SH. Impaired vascular endothelial growth factor signaling in the pathogenesis of neonatal pulmonary vascular disease[J]. Adv Exp Med Biol, 2010, 661:323-335.
[16] Cheng SL, Wang HC, Yu CJ, et al. Prevention of elastase-induced emphysema in placenta growth factor knock-out mice[J]. Respir Res, 2009, 10:115.
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