妊娠期高血压疾病子痫前期病变程度对婴幼儿听力情况影响的对比研究
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摘要
目的探讨不同程度妊娠期高血压疾病子痫前期对婴幼儿听力的影响及意义。方法收集石家庄市第四医院2015年1月至2017年12月母亲在妊娠期有妊娠期高血压疾病子痫前期史的1046例新生儿,按子痫前期的轻重程度,是否早产进行分组,进行听力检查,并与母亲无妊娠期高血压疾病子痫前期史的新生儿13 695例进行对比研究。结果在所研究的14 741例婴幼儿中,共有57例最终被诊断为感音神经性听力损失,总异常率0.39%(57/14 741)。其中母亲无妊娠期高血压疾病子痫前期的婴儿34例,异常率0.25%;母亲有轻度子痫前期的婴儿12例,异常率1.47%(12/815);母亲有重度子痫前期的婴儿11例,异常率4.76%(11/231)。轻度组与对照组、重度组与对照组、重度组与轻度组比较差异均具有统计学意义(P<0.01)。在足月儿中,共有33例最终被诊断为感音神经性听力损失,总异常率0.26%。其中母亲无妊娠期高血压疾病子痫前期的足月儿21例,异常率0.18%;母亲有轻度子痫前期的婴儿7例,异常率1.30%;母亲有重度子痫前期的婴儿5例,异常率3.91%。轻度组与对照组、重度组与对照组、重度组与轻度组比较差异均具有统计学意义(P<0.01、P<0.01、P<0.05)。在早产儿中,共有24例最终被诊断为感音神经性听力损失,总异常率1.09%。其中母亲无妊娠期高血压疾病子痫前期的婴儿13例,异常率0.71%;母亲有轻度子痫前期的婴儿5例,异常率1.81%;母亲有重度子痫前期的婴儿6例,异常率5.83%。轻度组与对照组比较差异无统计学意义(P>0.05),重度组与对照组、重度组与轻度组比较差异具有统计学意义(分别为P<0.01和P<0.05)。结论母亲患有重度妊娠期高血压疾病子痫前期的早产儿是听力损伤发生的高危人群,高血压程度越重,听力异常率越高。应重点加强对此类患儿的听力监测及随访,以便及早干预。
Objective To explore the influence and significance of preeclampsia with different degrees of gestational hypertension on infant hearing.Methods Totally 1046 newborns whose mothers had a history of pre-eclampsia with hypertensive disorder complicating pregnancy were divided into groups according to the severity of pre-eclampsia and whether they were premature or not from Jan. 2015 to Dec. 2017 in the Forth Hospital of Shijiazhuang.Hearing tests were conducted and compared with newborns whose mothers had no history of pre-eclampsia with hypertensive disorder complicating pregnancy.Results Of the 14 741 infants studied,57 were finally diagnosed with sensorineural hearing loss,with a total abnormality rate of 0.39%(57/14 741).Among them,34 infants with pre-eclampsia without hypertensive disorder complicating pregnancy had an abnormality rate of 0.25%.There were 12 infants with mild preeclampsia in their mothers,with an abnormality rate of 1.47%.There were 11 infants whose mothers had severe preeclampsia,with an abnormality rate of 4.76%.There were significant differences between mild group and control group,severe group and control group,and severe group and mild group(P<0.01).Among the term infants,33 cases were finally diagnosed as sensorineural hearing loss,with a total abnormality rate of 0.26%.Among them,21 full-term infants with pre-eclampsia without hypertensive disorder complicating pregnancy had an abnormality rate of 0.18%.There were 7 infants whose mothers had mild preeclampsia,with an abnormality rate of 1.30%.There were 5 infants with severe preeclampsia,with an abnormality rate of 3.91%.There were significant differences between mild group and control group,severe group and control group,and severe group and mild group(P<0.01,P< 0.01,P<0.05,respectively).Among premature infants,a total of 24 cases were finally diagnosed as sensorineural hearing loss,with an overall abnormality rate of 1.09%.Among them,there were 13 infants with preeclampsia whose mothers had no hypertensive disorder complicating pregnancy,with an abnormality rate of 0.71%.There were 5 infants with mild preeclampsia in their mothers,with an abnormality rate of1.81%.There were 6 infants with severe preeclampsia,with an abnormality rate of 5.83%.There was no significant difference between the mild group and the control group(P>0.05),but there was significant difference between the severe group and the control group,and between the severe group and the mild group(P<0.01 and P<0.05,respectively).Conclusion Premature infants with severe hypertensive disorder complicating pregnancy and preeclampsia are at high risk of hearing impairment.The higher the degree of hypertension,the higher the rate of hearing impairment.The emphasis should be put on strengthening the hearing monitoring and follow-up of such children.
Objective To explore the influence and significance of preeclampsia with different degrees of gestational hypertension on infant hearing.Methods Totally 1046 newborns whose mothers had a history of pre-eclampsia with hypertensive disorder complicating pregnancy were divided into groups according to the severity of pre-eclampsia and whether they were premature or not from Jan. 2015 to Dec. 2017 in the Forth Hospital of Shijiazhuang.Hearing tests were conducted and compared with newborns whose mothers had no history of pre-eclampsia with hypertensive disorder complicating pregnancy.Results Of the 14 741 infants studied,57 were finally diagnosed with sensorineural hearing loss,with a total abnormality rate of 0.39%(57/14 741).Among them,34 infants with pre-eclampsia without hypertensive disorder complicating pregnancy had an abnormality rate of 0.25%.There were 12 infants with mild preeclampsia in their mothers,with an abnormality rate of 1.47%.There were 11 infants whose mothers had severe preeclampsia,with an abnormality rate of 4.76%.There were significant differences between mild group and control group,severe group and control group,and severe group and mild group(P<0.01).Among the term infants,33 cases were finally diagnosed as sensorineural hearing loss,with a total abnormality rate of 0.26%.Among them,21 full-term infants with pre-eclampsia without hypertensive disorder complicating pregnancy had an abnormality rate of 0.18%.There were 7 infants whose mothers had mild preeclampsia,with an abnormality rate of 1.30%.There were 5 infants with severe preeclampsia,with an abnormality rate of 3.91%.There were significant differences between mild group and control group,severe group and control group,and severe group and mild group(P<0.01,P< 0.01,P<0.05,respectively).Among premature infants,a total of 24 cases were finally diagnosed as sensorineural hearing loss,with an overall abnormality rate of 1.09%.Among them,there were 13 infants with preeclampsia whose mothers had no hypertensive disorder complicating pregnancy,with an abnormality rate of 0.71%.There were 5 infants with mild preeclampsia in their mothers,with an abnormality rate of1.81%.There were 6 infants with severe preeclampsia,with an abnormality rate of 5.83%.There was no significant difference between the mild group and the control group(P>0.05),but there was significant difference between the severe group and the control group,and between the severe group and the mild group(P<0.01 and P<0.05,respectively).Conclusion Premature infants with severe hypertensive disorder complicating pregnancy and preeclampsia are at high risk of hearing impairment.The higher the degree of hypertension,the higher the rate of hearing impairment.The emphasis should be put on strengthening the hearing monitoring and follow-up of such children.
引文
[1]谢幸,苟文丽.妇产科学[M].8版.北京:人民卫生出版社,2013:64-70.
[2]陈惠球,陈敬国,黄超.早产儿AABR听力筛查初筛时间探讨[J].实用临床护理学电子杂志,2017,2(11):124-125.
[3]Iyyah L,Sibai B.Maternal mortality from preeclampsia/Eclampsia[J].Semin Perinatol,2012,36:56-59.
[4]Macdonaldwallis C,Tilling K,Fraser A,et al.Associations of blood pressure change in pregnancy with fetal growth and gestational age at delivery:findings from a prospective cohort[J].Hypertension,2014,64(1):36-44.
[5]Eliyahu S,Weiner E,Nachum Z.Epidemiologic risk factors for preterm delivery[J].Isr Med Assoc,2002,4(12):1115-1117.
[6]黄泽琴,景艳.妊娠期高血压疾病对新生儿神经行为影响的临床研究[J].中国现代药物应用,2014,8(13):13-14.
[7]Burguet A,Monnet E,Roth P,et al.Neurodevelopmental outcome of premature infants born at less than 33 weeks of gestational age and not cerebral palsy at the age of 5 years[J].Arch Pediatr,2000,7(4):357.
[8]窦晓宁,王爱华,任雪莲.妊娠期高血压综合征对足月婴儿听性脑干反应的影响[J].中国儿童保健杂志,2005,13(1):69-72.
[9]马秀兰.兰州市1106例新生儿听力损伤因素及干预效果分析[J].中国社区医师(综合版),2007,16(2):150-153.
[10]韩冰,历建强,兰兰.中国内地新生儿听力筛查情况的回顾性分析[J].听力学及言语疾病杂志,2012,20(1):6-11.
[11]许莹.新生儿重症监护病房早产儿听力损失的危险因素分析[C].第四届全国儿童耳鼻咽喉头颈外科高峰论坛论文集,2014:175-180.
[12]王国强,赵春红,霍红,等.早产儿听力筛查结果及其听力障碍危险因素[J].山东大学耳鼻喉眼学报,2015,4(1):7-10,14.
[13]郭少林.探究150例新生儿重症监护室早产儿听力筛查结果分析[C].河南省第二十六次儿科学术年会论文集,2015:314-315.
[14]陈学珍,魏蓉美,杨晋渝.416例重症监护室早产儿听力筛查结果及多因素影响分析[J].中国校医,2007,21(6):699-700.
[15]庄依亮,李笑天.病理产科学[M].北京:人民卫生出版社,2003:137-198.
[16]肖农,陈艳妮.重视我国早产儿及危重新生儿的发育行为及心理评定[J].中国实用儿科杂志,2017,32(11):807-812.
[17]赵慧贞,吴秋萍,刘清明,等.极低出生体重儿生长发育及神经发育状况140例临床研究[J].岭南急诊医学杂志,2015,20(2):137-139.
[18]张芳,马玉燕.高血压患者孕前和孕期风险评估及处理[J].中国实用妇科与产科杂志,2017,3(3):253-256.
[19]申叶,杨孜,陈杨.轻中度慢性高血压孕期血压维持和控制水平对母儿结局影响研究[J].中国实用妇科与产科杂志,2018,34(1):78-83.(2018-10-20收稿2018-11-30修回)
[2]陈惠球,陈敬国,黄超.早产儿AABR听力筛查初筛时间探讨[J].实用临床护理学电子杂志,2017,2(11):124-125.
[3]Iyyah L,Sibai B.Maternal mortality from preeclampsia/Eclampsia[J].Semin Perinatol,2012,36:56-59.
[4]Macdonaldwallis C,Tilling K,Fraser A,et al.Associations of blood pressure change in pregnancy with fetal growth and gestational age at delivery:findings from a prospective cohort[J].Hypertension,2014,64(1):36-44.
[5]Eliyahu S,Weiner E,Nachum Z.Epidemiologic risk factors for preterm delivery[J].Isr Med Assoc,2002,4(12):1115-1117.
[6]黄泽琴,景艳.妊娠期高血压疾病对新生儿神经行为影响的临床研究[J].中国现代药物应用,2014,8(13):13-14.
[7]Burguet A,Monnet E,Roth P,et al.Neurodevelopmental outcome of premature infants born at less than 33 weeks of gestational age and not cerebral palsy at the age of 5 years[J].Arch Pediatr,2000,7(4):357.
[8]窦晓宁,王爱华,任雪莲.妊娠期高血压综合征对足月婴儿听性脑干反应的影响[J].中国儿童保健杂志,2005,13(1):69-72.
[9]马秀兰.兰州市1106例新生儿听力损伤因素及干预效果分析[J].中国社区医师(综合版),2007,16(2):150-153.
[10]韩冰,历建强,兰兰.中国内地新生儿听力筛查情况的回顾性分析[J].听力学及言语疾病杂志,2012,20(1):6-11.
[11]许莹.新生儿重症监护病房早产儿听力损失的危险因素分析[C].第四届全国儿童耳鼻咽喉头颈外科高峰论坛论文集,2014:175-180.
[12]王国强,赵春红,霍红,等.早产儿听力筛查结果及其听力障碍危险因素[J].山东大学耳鼻喉眼学报,2015,4(1):7-10,14.
[13]郭少林.探究150例新生儿重症监护室早产儿听力筛查结果分析[C].河南省第二十六次儿科学术年会论文集,2015:314-315.
[14]陈学珍,魏蓉美,杨晋渝.416例重症监护室早产儿听力筛查结果及多因素影响分析[J].中国校医,2007,21(6):699-700.
[15]庄依亮,李笑天.病理产科学[M].北京:人民卫生出版社,2003:137-198.
[16]肖农,陈艳妮.重视我国早产儿及危重新生儿的发育行为及心理评定[J].中国实用儿科杂志,2017,32(11):807-812.
[17]赵慧贞,吴秋萍,刘清明,等.极低出生体重儿生长发育及神经发育状况140例临床研究[J].岭南急诊医学杂志,2015,20(2):137-139.
[18]张芳,马玉燕.高血压患者孕前和孕期风险评估及处理[J].中国实用妇科与产科杂志,2017,3(3):253-256.
[19]申叶,杨孜,陈杨.轻中度慢性高血压孕期血压维持和控制水平对母儿结局影响研究[J].中国实用妇科与产科杂志,2018,34(1):78-83.(2018-10-20收稿2018-11-30修回)