三亚地区早产儿视网膜病变流行现状及其母亲相关因素分析

Prevalence of retinopathy of prematurity in Sanya and analysis of its maternal related factors

摘要:

目的：了解三亚地区早产儿视网膜病变流行现状及探讨其相关危险因素，为该地区本病预防工作提供有利参考。

方法：选取2019-01/12期间在三亚市妇幼保健院分娩且胎龄小于36周的早产儿243例486眼和足月儿35例70眼作为研究对象，均进行眼底筛查，依据早产儿视网膜病变诊断标准统计其发病率，并收集所有母亲孕前及孕期相关资料进行单因素和多元Logistic回归分析。

结果：足月儿均未发生视网膜病变，早产儿确诊36例，其发病率约14.8%(36/243)。其中，Ⅰ期病变患儿约占58.3%，其次依次为Ⅱ期病变(30.6%)、Ⅲ期病变(8.3%)及Ⅳ病变(2.8%)，未发现Ⅴ期病变患儿。同时，阈值病变患儿2例(5.6%)。足月儿母亲与早产正常儿母亲除孕周外，在月经、孕龄、妊娠胎数、妊娠并发症相关因素中均无差异(P>0.05)，但与早产患病儿母亲均有差异(P<0.05)。月经不调、高龄妊娠、孕周短、多胎、子痫、妊娠期高血压综合征、糖尿病、围生期感染均是导致早产儿视网膜病变发病的高危因素(P<0.05)。

结论：三亚地区早产儿视网膜病变发病率较高，应予以高度重视，同时影响因素颇多，而孕前调理月经、避免高龄妊娠、足月分娩、单胎妊娠、控制妊娠并发症是降低该地区早产儿视网膜病变的有效方法。

Abstract:

AIM: To understand the epidemic situation of retinopathy of prematurity in Sanya region and its related factors analysis so as to provide a reference for the prevention of the disease in this region.

METHODS: A total of 243 premature infants(486 eyes)with gestational age of less than 36 weeks and 35 cases of full moon(70 eyes)who were delivered in Sanya Maternal and Child Health Care Hospital from January to December 2019 were selected as the research objects. Fundus screening was performed. And the incidence of retinopathy of prematurity was calculated according to the diagnostic criteria, and univariate and multivariate Logistic regression analysis was performed on the related data of the mothers before and during pregnancy.

RESULTS: There was no retinopathy in the whole moon, but 36 cases of premature infants with retinopathy of prematurity. And the incidence of the disease was 14.8%(36/243). Among them, about half(58.3%)of the children with stage Ⅰ disease. Followed by stage Ⅱ disease(30.6%), stage Ⅲ disease(8.3%)and stage Ⅳ disease(2.8%), no stage Ⅴ disease were found. Meanwhile, 2 children with threshold lesions(5.6%). Except for the gestational age, there were no significant differences in the related factors of menstruation, gestational age, gestational births and pregnancy complications between full-term and normal preterm mothers(P>0.05), but compared with the mothers of premature infants, the differences were statistically significant(P<0.05). The irregular menstruation, older pregnancy, gestational age short, polyembryony, eclampsia, PIH, diabetes and perinatal infection were independent risk factors for retinopathy of prematurity(P<0.05).

CONCLUSION: The incidence of retinopathy of prematurity is high in Sanya, which should be paid great attention. At the same time, there are many influencing factors. It is an effective method to reduce retinopathy of prematurity in this area that menstrual conditioning before pregnancy, avoid advanced pregnancy, term birth, monocyesis and control pregnancy complications.