Journal of Developmental Medicine(Electronic Version)  2022, Vol. 10 Issue (5): 365-372 DOI: 10.3969/j.issn.2095-5340.2022.05.007 |
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| Analysis of effects of maternal diseases on neonates and risk factors for small for gestationalage in preterm infants |
| FangG Xiaoyi, Zou Xinfei, Li uanming, et al
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(1. Department of Neonatology, the Seventh Affiliated Hospital, Sun Yat-sen University, Guangdong,Shenzhen 518107, China; 2. Department of Pediatric Intensive Care Unit, Maternal and Children Hospitalof Guangdong Province, Guangdong, Guangzhou 511400, China; 3. Department of Neonatology, the FirstAffiliated Hospital, Shantou University Medical College, Guangdong, Shantou 515041, China)
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Abstract 【Abstract】 Objective To explore the effects of maternal diseases on neonates and risk factors for smallfor gestational age (SGA) in premature infants. Method Data of the 3 387 newborns and their maternalstransferred from the Department of Obstetrics to Neonatology, the First Affiliated Hospital, ShantouUniversity Medical College, from January 2013 to December 2017 were collected and the effects of thematernal origins diseases on newborn were analyzed. The 1 794 premature infants were divided into the SGAgroup (n=303) and non-SGA group (n=1 491). The risk factors from mother, including premature rupture ofthe membrane (PROM), advanced maternal age (AMA, >35 years old), gestational diabetes mellites (GDM),gestational hypertension, multiple pregnancy, parity, in-vitro fertilization, intrauterine infection, hepatitis B,vaginitis, thyroid dysfunction, prenatal anemia, systemic lupus erythematosus (SLE), cholestasis, hemolysis,elevated liver function and low platelet count (HELLP) syndrome, placental abruption and placenta previa,which might affect the occurrence of SGA in premature infants were analyzed by multivariate Logisticregression and the predictive efficiency was evaluated. t-test, χ2 test, receiver operating characteristic (ROC)and area under the curve (AUC) were used for statistical analysis Result ①The main diseases of thenewborn infants transferred from the Department of Obstetrics were prematurity [1 794/3 387 (52.97%)], lowbirth weight [1 631/3 387(48.15%)], pathological jaundice [1 176/3 387 (34.72%)], pneumonia [1 117/3 387(32.97%)] and SGA [610/3 387 (18.01%)]. ②The infants in PROM group had a lower gestational age (GA),a lower birth weight (BW), a lower incidence of SGA, and a higher incidence of pneumonia and intracranialhemorrhage (IVH) compared with the non-PROM group (P<0.05). The newborns in AMA group had a lowerGA compared with the non-AMA group (P<0.05). The newborns of primiparity mother in AMA group hada higher incidence of hypoglycemia compared with the multiparity mother in AMA group [26/147(17.69%)vs 47/426(11.03%), P<0.05]. The infants of diabetes mother (IDM) had a higher BW, a higher incidence ofhypoglycemia, and a lower incidence of SGA and hypoxic ischemic encephalopathy (HIE) compared withthe non-IDM group (P<0.05). The infants of hypertension mother had a lower GA, a lower BW, a higherincidence of SGA, neonatal respiratory distress syndrome (NRDS), asphyxia, hypoglycemia and a lowerincidence of pathological jaundice compared with the non-hypertension group (P<0.05). The infants born bymultiple pregnancy had a lower GA, a lower BW, a higher incidence of SGA, NRDS and hypoglycemia, anda lower incidence of pathological jaundice and HIE compared with the singular pregnancy group (P<0.05).③Multivariate Logistic regression analysis showed that primipara (OR=1.382, 95%CI: 1.061-1.801),gestational hypertension (OR=4.270, 95%CI: 3.155-5.779) and multiple pregnancy (twin OR=1.561, 95%CI:1.155-2.110, triplet OR=2.690, 95%CI: 1.180-6.133) were the independent factors of SGA in prematureinfants (all P<0.05). Conclusion The main problems of the mother are PROM, AMA, GDM, gestationalhypertension, multiple pregnancy, and so on. Primipara, gestational hypertension and multiple pregnancy are the independent risk factors contributing to the SGA in premature infants.
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Received: 04 January 2022
Published: 30 September 2022
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