RISK-FACTORS FOR RESPIRATORY-DISTRESS SYNDROME IN THE NEWBORN - A MULTICENTER ITALIAN SURVEY
RISK-FACTORS FOR RESPIRATORY-DISTRESS SYNDROME IN THE NEWBORN - A MULTICENTER ITALIAN SURVEY
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DOI：
10.3109/00016349309021113
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发表时间：
1993-07-01
影响因子：
4.3
通讯作者：
BEVILACQUA, G
中科院分区：
文献类型：
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作者：
LUERTI, M;PARAZZINI, F;BEVILACQUA, G
在新生儿呼吸窘迫综合征（RDS）的危险因素进行了评估，使用1980年和1989年之间进行的一项大型调查的数据，在选定的时期，在11个围产期单位放置在五个意大利地区。共有1624名在合作中心连续分娩的活产婴儿，分娩时胎龄为26-37周，无临床明显的先天性异常。所有新生儿随访至出生后第28天。共131例新生儿（7.8%）发生RDS。出生后第1 - 7天和第1 - 28天的婴儿死亡率分别为54.8/1，000和61.6/1，000活产;患RDS的婴儿的相应死亡率分别为419.8/1，000和465.6/1，000活产。男性RDS的发生率高于女性，相应的相对危险度RR为0.7，95%可信区间CI为0.5 ~ 0.9。RDS的风险随着出生体重的降低而显著增加：与出生时体重超过2500 g的婴儿相比，体重> 2000-2500 g、> 1500- 2000 g、> 1000-1500 g和1000 g或更少的婴儿的RR估计值分别为1.4、4.5、8.8和39.3。同样，与妊娠35 ~ 37周出生的婴儿相比，妊娠31 ~ 34周或31周以前出生的婴儿RDS的RR分别为3.3和21.5。多胎妊娠、妊娠期糖尿病或慢性糖尿病、妊娠高血压或慢性高血压、胎膜早破与RDS风险无关。在RDS病例中，有5名母亲（3.8%）报告了妊娠期吸烟，在未发生疾病的病例中有83名母亲（9.3%）报告了妊娠期吸烟：相应的RR为0.4，95%CI范围为0.2 - 0.9。与阴道分娩相比，产时剖宫产分娩的婴儿发生RDS的风险增加（RR 1.8，95% CI 1.2 - 2.7），但择期剖宫产分娩的婴儿风险没有显著降低（RR 0.5，95% CI 0.3 - 1.1）。第1分钟和第5分钟的低Apgar评分（小于7）与RDS风险增加相关，与Apgar评分等于7或更高的婴儿相比，RR估计值为1分钟时7.9，5分钟时8.4。
Risk factors for respiratory distress syndrome (RDS) in the newborn have been evaluated using data from a large survey conducted between 1980 and 1989 in selected periods in eleven perinatal units placed in five Italian regions. A total of 1624 liveborn infants consecutively delivered at the collaborating centers, at delivery 26-37 weeks gestational age and without clinically evident congenital anomalies were included in the survey. All the newborns were followed up to the 28th day of life. A total of 131 newborns (7.8%) developed RDS. Overall 1st-7th and 1st-28th day of life infant mortality rates were 54.8 and 61.6/1,000 livebirths; the corresponding rates in babies who developed RDS were 419.8 and 465.6/1,000 livebirths. The frequency of RDS was higher in males than in females and the corresponding relative risk, RR, was 0.7, with 95% confidence interval, CI, ranging from 0.5 to 0.9. The risk of RDS markedly increased with decreasing birth weight: compared to babies weighing more than 2500 g at birth the RR estimates were respectively 1.4, 4.5, 8.8 and 39.3 in those weighing > 2000-2500 g, > 1500-2000 g, > 1000-1500 g and 1000 g or less. Likewise, compared to babies born between the 35th and the 37th week of gestation, the RR of RDS was 3.3 and 21.5 in those born between the 31st-34th or before the 31st week of gestation. Multiple pregnancy, gestational or chronic diabetes, pregnancy-induced or chronic hypertension and premature rupture of the membranes were not related to the risk of RDS. Smoking in pregnancy was reported by five mothers among cases with RDS (3.8%) and 83 among those who did not develop the disease (9.3%): the corresponding RR was 0.4 with 95% CI ranging from 0.2 to 0.9. Compared to vaginal births, babies delivered by intrapartum cesarean section had an increased risk of RDS (RR 1.8, 95% CI from 1.2 to 2.7), but babies delivered by elective cesarean section were at not significantly decreased risk (RR 0.5, 95% CI 0.3 to 1.1). Low Apgar score at 1st and 5th minute (less than 7) was associated with an increased risk of RDS, the RR estimates being, compared to babies with Apgar score equal to 7 or more, 7.9 at 1 minute of age and 8.4 for 5 minutes of age.