Analysis Of Maternal Factor Of 100 Cases Of Neonatal Hypoxic-ischemic Encephalopathy

Objective:To explore the risk factors related to neonatal hypoxic-ischemic encephalopathy,screening and early identification of high-risk pregnant women associated with HIE,so as to optimize the timing of termination of pregnancy and improve maternal and infant prognosis.Research materials and methods:Retrospective analysis was performed on A total of 100 cases of pregnant women who delivered HIE children in our hospital from January2013 to December 2019(excluding labor induction due to fetal malformation or personal reasons),and they were divided into group A(mild HIE group)with 47 cases and group B(moderate and severe HIE group)with 53 cases.Nonparametric test and Logistic regression analysis were used to analyze the independent risk factors related to the severity of the disease and the correlation between each factor and neonatal hypoxic-ischemic encephalopathy.SPSS 25.0 statistical software was used for statistical analysis of the data.Mean ± standard deviation was used for measurement data conforming to normal distribution,and t test or analysis of variance was used for comparison between groups.Measurement data that do not conform to the normal distribution are represented by the median(P25,P75).Enumeration data were expressed by frequency and percentage.Chi-square test was used for comparison between groups.If the expected number of data in the four-grid table was less than 5,Fisher’s exact probability method was used for data calculation.P < 0.05 was statistically significant.Results:(1)To summarize the general situation of neonatal infants with hypoxic-ischemic encephalopathy during 7 years of delivery.There was no statistical significance in the distribution of gestational age and age between the two groups,but the pregnant women in HIE children showed advanced age,high weight gain,irregular pregnancy and childbirth,multiple childbirth history,high history of induced abortion,and high rate of premature birth.(2)There were statistically significant differences between the two groups in pregnancy complications(combined with pregnancy hypertension disease,combined with heart failure),childbirth complications(fetal distress),and laboratory indicators(total bile acid,alanine aminotransferase,free thyroxine T4).The main manifestations of fetal distress are frequent late deceleration,sine wave,fetal heart loss,and moderate and severe HIE are more likely to show intrauterine distress.(3)There was no statistical significance between the severity of HIE disease and delivery mode or cesarean anesthesia mode.(4)There was no significant difference in dystocia between the two groups(P > 0.05).In group A(mild HIE group),dystocia occurred in 9 cases,including 2 cases of cesarean section after dystocia and 7 cases of vaginal delivery,among which 3 cases of postpartum hemorrhage and 2 cases of vaginal wall hematoma occurred.In Group B(moderate and severe HIE group),5 cases of dystocia were terminated by cesarean section,but 1 case was complicated with abdominal wall hematoma.(5)Combined intrauterine distress(P=0.030,OR=2.354)and elevated free thyroxine T4(P=0.002,OR=1.321)were risk factors for adverse neonatal outcomes.The more severe the intrauterine distress,the higher the content of free thyroxine T4,the greater the risk of moderate to severe HIE.(6)Neonatal data: there were significant differences in the severity of neonatal asphyxia,type of assisted respiration,neonatal rescue,number of complications,acid-base decompensation and creatine kinase isoenzyme between the two groups(P < 0.05).Conclusion:(1)HIE is associated with maternal factors(pregnant women complicated with hypertensive disease during pregnancy,heart failure,fetal distress,or abnormal total bile acid,alanine aminotransferase,free thyroxine T4),which should be closely monitored to prevent the occurrence of poor prognosis.(2)Neonatal hypoxic-ischemic encephalopathy is closely related to complications and complications during pregnancy,and prenatal examination should be standardized to detect complications such as heart failure in the early stage.According to the needs of the disease and active treatment,early intervention.(3)Natural delivery,cesarean section and other delivery methods have no correlation with the severity of HIE.Therefore,natural delivery should be encouraged,indications of cesarean section should be strictly controlled,and appropriate delivery methods and anesthesia methods should be selected according to the patient’s condition.(4)Neonatal hypoxic-ischemic encephalopathy is closely related to maternal factors,which requires mutual assistance and active communication between obstetricians and neonatologists to jointly improve the outcomes of mothers and infants.(5)The occurrence time of all kinds of sequelae of neonatal hypoxic-ischemic encephalopathy varies from time to time,so close follow-up is needed to pay attention to the growth and development of neonates.