新生儿重症监护病房宫内感染的发生率:长期流行病学分析

O. Kuznetsova, A. Marchenko
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摘要

的目标。改善新生儿重症监护病房的流行病学监测。材料与方法。我们回顾性分析了在秋明围产期中心分娩并入住新生儿重症监护病房的646例新生儿的病例史(310例有宫内感染,336例无宫内感染)。通过多因素分析和logistic回归分析确定宫内感染的预测因素(优势比和95%可信区间)。多因素分析显示,流产病史、尿路感染、妊娠期早产、阴道炎、阴道炎、白细胞增多、c反应蛋白升高、贫血、胎儿血供受损是宫内感染的预测因素。逐步logistic回归确定了与宫内感染相关的7个显著特征:白细胞增多、贫血、羊水病理改变、早产、胎儿血液供应受损、新生儿呼吸窘迫综合征和新生儿中枢神经系统损伤。预后模型的敏感性和特异性分别为87.7%和83.9%。该预测模型可用于产前和围生期宫内感染的预测和验证。
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Incidence of intrauterine infections in neonatal intensive care unit: a long-term epidemiological analysis
Aim. To improve epidemiological surveillance in the neonatal intensive care unit.Materials and Methods. We retrospectively examine case histories of 646 newborns delivered in Tyumen Perinatal Center and admitted to neonatal intensive care unit (310 with intrauterine infection and 336 without intrauterine infection). Predictors of intrauterine infection (odds ratio and 95% confidence interval) were determined by means of multivariate analysis and logistic regression analysis.Results. According to the multivariate analysis, past medical history of abortions, urinary tract infections, preterm birth during previous pregnancy, colpitis, vaginitis, leukocytosis, elevated C-reactive protein, anemia, and impaired fetal blood supply were among the predictors of intrauterine infection. Stepwise logistic regression identified 7 significant features associated with intrauterine infection: leukocytosis, anemia, pathological alterations in amniotic fluid, preterm birth, impaired fetal blood supply, newborn respiratory distress syndrome, and injury of the newborn central nervous system. Sensitivity and specificity of the prognostic model were 87.7% and 83.9%.Conclusion. Our prognostic model might be applicable for the prediction and verification of intrauterine infection during the prenatal and perinatal observation.
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