The Relationship Between Intrauterine Infection And Neonatal Respiratory Distress Syndrome

Background: With the development of perinatal medicine technology andassisted reproductive technology and the change of the concept of life of people,preterm infants birth rate significantly increased, resulting in the incidence of neonatalrespiratory distress syndrome(NRDS) increase. NRDS is one of the most commondisorders of neonatal respiratory and is an important cause of neonatal death. In recentyears, the application of exogenous pulmonary surfactant (PS) and assisted ventilationplays an important role in the prevention and treatment of this disease, however, thesurvived children after rescued still left over chronic lung disease, nervous systemdamage and retinopathy, seriously affecting the quality of life of children. NRDSoccurs mainly due to lung of immature leading to lack of PS. The synthesis of PS canbe affected by pH value, body temperature, pulmonary blood flow and hormones etc.Therefore, perinatal asphyxia, hypothermia, placenta previa, placental abruption,hypovolemia induced by fetal mother hypotension, gestational diabetes, cesareansection can induce NRDS. Of course, premature delivery is the most important factorof lack of PS. The smaller the gestational age, the higher the incidence of NRDS.Studies have shown that about20%to40%premature delivery is induced by infection,so infection is an important cause of premature delivery. More than90%pretermdelivery occurs in24to28weeks have relations with infection and80%of pretermdelivery before30weeks is due to infection. Thus there is a close relationshipbetween intrauterine infection and NRDS.Therefore, further exploring the relationshipbetween intrauterine infection and NRDS has important academic value and practicalsignificance for the prevention, diagnosis and treatment of NRDS.Objective：To explore the relationship between intrauterine infection and NRDS,for the medical staff to provide a reference for the development of prevention andcontrol measures of NRDS, thereby reduce the incidence and mortality of NRDS andpromote newborn healthy. Methods: A retrospective case-control study was conducted on the preterminfants who were delivered and hospitalized in our hospital from June2010toSeptember2013, and the infants were divided into two groups: NRDS group and noneNRDS group. The database was set up, and single factor analysis and multivariatelogistic regression were carried out by SPSS software.Results: Factors concerned with NRDS displayed by single factor analysis showthat: birth weight, gestational age, Apgar scores, stained amniotic fluid, prematurerupture of membranes, use of hormones before birth, neonatal sepsis. While some ofthe others have no significant differences, such as gender, mode of delivery,intrauterine infection, use of antibiotic before birth. Multivariate logistic regressionshows that: some of the concerned factors are risk factors which may increase the riskof NRDS, such as low birthweight(OR=21.724,95%CI:13.541,86.239), lowgestational age(OR=33.709,95%CI:21.584,126.479), low Apgar score(OR=18.370,95%CI:7.015,67.403), second/third degree stained amniotic fluid(OR=3.250,95%CI:1.118,11.020/OR=8.207,95%CI:1.083,17.217), premature rupture ofmembranes(OR=2.550,95%CI:3.113,9.294), neonatal sepsis(OR=3.103,95%CI:1.332,7.229), while use of hormones before birth(OR=0.299,95%CI:0.125,0.717)can prevent NRDS.Conclusion: Factors associated infections: stained amniotic fluid, prematurerupture of membranes and neonatal sepsis are risk factors of NRDS, while intrauterineinfection is not.