Risk factors of post-asphyxial multiple organ dysfunction in neonates

LIU Jun-Yan; XIONG Tao; FENG Hong; QU Yi; YE Qiang-Hua; MU De-Zhi

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Chinese Journal of Contemporary Pediatrics ›› 2011, Vol. 13 ›› Issue (12) : 940-943.

CLINICAL RESEARCH

Risk factors of post-asphyxial multiple organ dysfunction in neonates

LIU Jun-Yan, XIONG Tao, FENG Hong, QU Yi, YE Qiang-Hua, MU De-Zhi

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Abstract

OBJECTIVE: To investigate the risk factors related to post-asphyxial multiple organ dysfunction (PA-MOD) in neonates. METHODS: A total of 397 neonates with birth asphyxia were enrolled from January 2009 to December 2010.The patients were divided into PA-MOD group (n=179) and non-PA-MOD group (n=218). The risk factors of PA-MOD were retrospectively studied. RESULTS: Multivariate logistic regression analysis showed that severe asphyxia, fetal distress, abnormal labor, and decreased amniotic fluid were the risk factors for PA-MOD among the neonates. Spearman rank correlation analysis showed that the number of the involved organs increased along with the increase of age at admission (P<0.05) and with the decrease of gestational age and birth weight (P<0.05). CONCLUSIONS: The efforts should be made to enhance perinatal care for neonates, especially for preterm infants and low-birh-weight infants, to decrease the incidence of MOD.

Key words

Asphyxia / Multiple organ dysfunction / Risk factor / Neonate

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LIU Jun-Yan, XIONG Tao, FENG Hong, QU Yi, YE Qiang-Hua, MU De-Zhi. Risk factors of post-asphyxial multiple organ dysfunction in neonates[J]. Chinese Journal of Contemporary Pediatrics. 2011, 13(12): 940-943

References

［1］Rudan I, Chan KY, Zhang JS, Theodoratou E, Feng XL, Salomon JA, et al. Causes of deaths in children younger than 5 years in China in 2008［J］. Lancet, 2010, 375（9720）: 1083-1089.

［2］周丹，邓肖群.新生儿窒息多脏器血流动力学研究［J］. 甘肃科技，2009，25（8）：144-148.

［3］王丽芳，丁守领，顾圆. 104例新生儿窒息致多器官损伤临床分析［J］. 中国现代药物应用，2010，4（17）：59-61.

［4］虞人杰，李黎汤，汤铎中. 新生儿窒息多器官损害的临床研究［J］. 中华儿科杂志，1997，35（3）：138-141.

［5］张秀英，胡玲，高燕勤，赵国华，郑仪宁.49例窒息新生儿器官功能损害的临床分析［J］.医学信息，2011，24(1):91-92.

［6］钟韩荣，古汉礼. 新生儿窒息并多脏器损害的危险因素分析［J］. 实用医学杂志，2000，16（12）：1037.

［7］朱建幸，周晓苓，朱晓东.新生儿重度窒息器官损害及死亡危险因素分析［J］.中国当代儿科杂志, 2005, 7（5）: 389-392.

［8］崔其亮，冯志明，黄伟，陈立民. 新生儿多器官系统损害临床特点与危险因素分析［J］.小儿急救医学，2001，8（2）：94-95.

［9］Hogan L, Ingemarsson I, Thorngren-Jerneck K, Herbst A. How often is a low 5-min Apgar score in term newborns due to asphyxia?［J］.Eur J Obstet Gynecol Reprod Biol, 2007, 130(2): 169-175.

［10］Martin-Ancel A, Garcia-Alix A, Gaya F, Cabanas F, Burgueros M, Quero J. Multiple organ involvement in perinatal asphyxia［J］.J Pediatr, 1995, 127(5): 786-93.

［11］Hankins GD, Koen S, Gei AF, Lopez SM, Hook JW, Anderson JD. Neonatal organ system injury in acute birth asphyxia sufficient to result in neonatal encephalopathy［J］.Obstet Gynecol, 2002, 99(5 Pt 1): 688-691.

［12］温婷媛，孙丽芳，刘庆研，吕艳伟.宫内窘迫对新生儿血清心肌酶水平的影响［J］.中国新生儿科杂志，2011，25（4）：223-225.

［13］Low JA, Lindsay BG, Derrick EJ. Threshold of metabolic acidosis associated with newborn complications［J］.Am J Obstet Gynecol, 1997, 177(6): 1391-1394.

［14］黄帅，漆洪波，李莉.未足月胎膜早破孕妇剩余羊水量与母儿结局［J］.中华妇产科杂志,2009,44（10）: 726-730.

［15］Shanks A, Tuuli M, Schaecher C, Odibo AO, Rampersad R. Assessing the optimal definition of oligohydramnios associated with adverse neonatal outcomes［J］. J Ultrasound Med, 2011, 30(3): 303-307.

［16］Kim BJ, Romero R, Mi Lee S, Park CW, Shin Park J, Jun JK, et al. Clinical significance of oligohydramnios in patients with preterm labor and intact membranes［J］. J Perinat Med, 2011, 39(2): 131-136.

［17］Butt FT, Ahmed B. The role of antepartum transabdominal amnioinfusion in the management of oligohydramnios in pregnancy［J］. J Matern Fetal Neonatal Med, 2011, 24(3): 453-457.

［18］Lauria MR, Gonik B, Romero R. Pulmonary hypoplasia: pathogenesis,diagnosis and antenatal rediction［J］. Obstet Gynecol, 1995, 86(3): 466-475.

［19］Shah P, Riphagen S, Beyene J, Perlman M. Multiorgan dysfunction in infants with post-asphyxial hypoxic-ischaemic encephalopathy［J］. Arch Dis Child Fetal Neonatal Ed, 2004, 89(2): F152-F155.

［20］Shastri AT, Samarasekara S, Muniraman H, Clarke P. Cardiac troponin I concentrations in neonates with hypoxic-ischaemic encephalopathy［J/OL］. Acta Paediatr, 2011, doi: 10.1111/j.1651-2227.2011.02432.x.

［21］林丽星，毛庆花，张志玲，安彩霞，康曦光.N端脑钠肽原和糖原磷酸化酶同工酶BB在新生儿窒息合并心肌损伤中的变化［J］.中国当代儿科杂志，2010,12(4):252-255.

［22］Matter M, Abdel-Hady H, Attia G, Hafez M, Seliem W, Al-Arman M. Myocardial performance in asphyxiated full-term infants assessed by Doppler tissue imaging［J］. Pediatr Cardiol, 2010, 31(5): 634-642.

［23］李朝晖.新生儿窒息后血胃泌素、胃液PH值与胃肠功能障碍关系［J］.浙江实用医学，2010,15(1):58-59.

［24］Tarcan A, Tiker F, Guvenir H, Gurakan B. Hepatic involvement in perinatal asphyxia［J］. J Matern Fetal Neonatal Med, 2007, 20(5): 407-410.

［25］Durkan AM, Alexander RT. Acute kidney injury post neonatal asphyxia［J］.J Pediatr, 2011, 158(2 Suppl): e29-33.