Objective To analyze the impact of obstetric risk factors on neonatal hypoxic ischemic encephalopathy ( HIE ). Methods The clinical data of 82 newborns with HIE from January 2009 to December 2011 was analyzed. Results Fetal distress, preeclampsia, umbilical cord factors, oligohydramnios, neonatal asphyxia and placental factors were the main risk factors of HIE at perinatal period (χ2 value was 74.81, 14.75, 25.51, 12.92, 117.88 and 4.51, respectively, all P<0.05 ), and OR value and 95% confidence limit of fetal distress and neonatal asphyxia were 10. 56 ( 5. 88-18. 98 ) and 20. 73 ( 11. 08-38. 77 ), respectively. The incidence of neonatal HIE in patients undergoing vaginal operation elevated significantly ( OR = 6. 20, P < 0. 01 ), but there was no significant difference between newborns by vaginal delivery and cesarean section ( both P > 0. 05 ). Non-conditional multivariate Logistic regression analysis indicated that fetal distress, neonatal asphyxia, oligohydramnios and vaginal operation production were independent risk factors of HIE, and adjusted OR values were 8. 23 , 21. 26, 2. 34 and 4. 28, respectively ( all P < 0. 05 ). Conclusion Strengthening prenatal care, detecting and treating high-risk pregnancy timely and improving the obstetric technique are very important to prevent the occurrence of HIE.%目的 分析产科各种危险因素对新生儿缺氧缺血性脑病发病的影响.方法 回顾性分析2009年1月至2011年12月新生儿缺氧缺血性脑病患儿82例的临床资料.结果 两组的胎儿窘迫、子痫前期、脐带因素、羊水过少、新生儿窒息、胎盘因素是主要围产期危险因素(χ2值分别为74.81、14.75、25.51、12.92、117.88、4.51,均P<0.05);其中胎儿窘迫、新生儿窒息的OR值和95%可信限分别为10.56(5.88~18.98)和20.73(11.08~38.77);阴道手术产者新生儿缺氧缺血性脑病的发生率明显升高(OR=6.20,P<0.01),而顺产和剖宫产者比较无显著性差异(均P>0.05).非条件多元Logistic回归分析提示胎儿窘迫、新生儿窒息、羊水过少、阴道手术产是新生儿缺氧缺血性脑病的独立危险因素,矫正OR分别为8.23、21.26、2.34、4.28,均P<0.05.结论 加强产前检查,及时发现和处理高危妊娠,提高产科技术,对预防新生儿缺氧缺血性脑病的发生有非常重要的意义.
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