The Analysis Of Related Factors To Iatrogenic Premature Delivery And Pregnancy Outcome

ObjectiveTo study the constitute factors and related factors ratio of iatrogenic preterm delivery,and the effect of different pregnancy weeks and different body weight in birth on neonatal outcome and preterm infants outcome induced by different causes.Materials and Methods1 Research subjectsThe 2108 cases of iatrogenic premature delivery and infants in the third affiliated hospital of Zhengzhou University were named as the experiment subjects during the period from March 2012 to February 2015.The constitute factors and related factors ratio of iatrogenic preterm delivery were analyzed including hypertension,gestational diabetes,placenta,placental abruption,uterine factor,intrahepatic cholestasis in pregnancy,abnormal amniotic fluid,and medical/surgical disease complications.The infant outcome of iatrogenic preterm delivery was observed.2 Research indexThe retrospective analysis of iatrogenic premature delivery and infant outcome were done.The 2108 patients of iatrogenic premature delivery were classified according the different disease causes and analyzed the constitute ratio?excluding fetal malformation,stillbirth,twin pregnancy and unplanned pregnancy termination of pregnancy?;infant outcome:1.Three groups were divided according the different pregnancy weeks:early preterm group(pregnancy age 28³1⁺⁶ weeks)of 422 cases,middle preterm group(pregnancy age 32³3⁺⁶ weeks)of 608 cases,late preterm group(pregnancy age 34³6⁺⁶ weeks)of 1078 cases.2.Four goups were divided according to the body weight in birth:normal birth weight group?birth weight?2500g?of 298 cases,low birth weight group?1500 g?birth weight<2500 g?of 1252cases,very low birth weight group?1000g?birth weight<1500 g?of 521 cases,and extremely low birth weight group?birth weight<1000 g?of 37 cases.The comparison of neonatal asphyxia?infant Apgar score<7?,respiratory distress syndrome,neonatal pneumonia,neonatal hypoxic ischemic encephalopathy,hyperbilirubinemia,and mortality.3.The rate of neonatal asphyxia,respiratory distress syndrome and mortality of different pregnancy weeks in gestational hypertension,placenta previa and intrahepatic cholestasis of pregnancy groups.3 Statistical analysisThe data were analysed by SPSS 17.0 software.The single factor analysis of risk factors of preterm birth with?² test.The measurement data of normal distribution were represented as x±s,and the comparison between groups was performed by the single factor analysis of variance.Difference with P<0.05 were regarded as statistically difference.Results1 The related factors and ratio of iatrogenic premature deliveryIn the related factors of iatrogenic premature delivery,the one of the top three causes was hypertensive disorders in pregnancy with 906 cases?42.98%?,placenta previa with 389 cases?18.45%?and fetal distress with 205 cases?9.72%?,which the first related factor of iatrogenic premature delivery was hypertensive disorders in pregnancy.In placenta,fetal distress,fetal intrauterine growth restriction with 170cases?8.06%?,intrahepatic cholestasis of pregnancy with 142 cases?6.74%?,amniotic fluid factors with 112 cases?5.31%?,placental abruption with 99 cases?4.70%?,gestational diabetes mellitus with 56 cases?2.66%?,HELLP syndrome with50 cases?2.37%?,and medical and surgical disease of pregnancy with 29 cases?1.38%?.2 The effect of different pregnancy weeks on preterm infants outcome in all groupsWith the increasing of pregnancy weeks,the incidence of complications such as premature asphyxia,neonatal respiratory distress?NRDS?,neonatal pneumonia and neonatal mortality rate were significantly reduced,the incidence of hyperbilirubinemia was gradually increased between the groups with statistical difference?P<0.05?.3 The effect of different body weight on preterm infants outcome in all groupsWith the increasing of body weight,the incidence of complications such as neonatal asphyxia,neonatal respiratory distress,and neonatal pneumonia were obviously reduced,the incidence of hyperbilirubinemia was gradually increased between the groups with statistical difference?P<0.05?.4 The preterm infant outcome of different pregnancy weeks in gestational hypertension,placenta previa and intrahepatic cholestasis of pregnancy groups.Early preterm group?28³2 weeks?:there were obvious difference of the incidence of neonatal asphyxia and NRDS in placenta previa and intraphepatic cholestasis groups.Compared with the aboved two groups,the incidence of preterm infant was significantly decreased in gestational hypertension group?P<0.05?;there were no obvious difference in neonatal mortality in three groups.Middle preterm group(32³3⁺⁶ weeks):there were no obvious difference of the incidence of neonatal asphyxia,NRDS and neonatal mortality in placenta previa and intraphepatic cholestasis groups.Compared with the aboved two groups,the incidence of preterm infant was significantly decreased in gestational hypertension group?P<0.05?.Late preterm group?34³6 weeks?:there were no obvious difference of the incidence of neonatal asphyxia,NRDS and neonatal mortality in placenta previa group,intraphepatic cholestasis group,and gestational hypertension group.Conclusions1.Adhere to the regular prenatal pregnancy,early found early treatment,can actively to avoid and reduce the occurrence of iatrogenic prematurity labor.2.In the treatment of iatrogenic preterm labor,should be comprehensive assessment,to develop individualized programs,in the case of illness allows can extend gestational age,in the right time to take the right opportunity to terminate pregnancy.