بررسي شيوع زايمان‌هاي خيلي زودرس، عوامل خطر و عواقب نوزادي در بيمارستان آرش: گزارش كوتاه

The prevalence of very preterm deliveries, risk factors, and neonatal complications in Arash women hospital: a brief report

زمينه و هدف: زايمان زودرس بيش‌ترين تأثير را در شاخص ميزان مرگ‌و‌مير نوزادان دارد. اين مطالعه با‌هدف بررسی شيوع زايمان بسيار زودرس (32-26 هفته)، عوامل خطر و عوارض نوزادی زودرس آن (28 روز اول زندگی يا كم‌تر) انجام شد.روش بررسی: اين مطالعه به‌روش توصيفی- مقطعی گذشته‌نگر انجام شد. از 4393 مورد زايمان در بيمارستان آرش در سال 1388، 59 زايمان و 79 تولد، بسيار زودرس بود كه از نظر عوامل خطر مادری، و عوارض نوزادی بررسی شدند.يافته‌ها: از 59 زن باردار، 12/27% حاملگی چند‌قلو و 12/27% پارگی زودرس پرده‌های جنينی داشتند. در حدود نيمی از نوزادان وزن بسيار پايين تولد، 74 نفر (93/67%) سندرم ديسترس تنفسی و 13 مورد مرگ گزارش شد.نتيجه‌گيری: زايمان زودرس يك پديده چندعلتی است و شناسايی علل خطر و جلب مشاركت مادران باردار و بالابردن آگاهی آن‌ها می‌تواند در كاهش ابتلا به آن مؤثر باشد.

Background: Very preterm birth (26-32 weeks) has an important effect on infant morta-lity and disability of infancy. The aim of this study was to investigate the prevalence of very preterm delivery and early neonatal morbidity (the first 28 days after birth).Methods: In this cross-sectional retrospective study, among 4393 delivery in Arash Womenʹs Hospital in Tehran, 59 deliveries were very preterm that resulted in 79 very preterm neonate births. We assessed maternal risk factors and neonatal complications in women who were admitted for delivery from March 2009 to March 2010.Results: Among 59 pregnant women, 17 (12/27%) had multiple pregnancies and 17 (12/27%) had premature rupture of fetal membranes. Caesarean section method was more common than normal vaginal delivery (46 cases- 97/77%). Women aged 18 to 35 had the highest rate of preterm delivery (45/86%). Among 79 very preterm neonates about half of them were very low birth weight, 74 neonates (93/67%) suffered from respiratory distress syndrome and 13 deaths were reported.Conclusion: Premature birth is a multi-factorial phenomenon. Identifying maternal risk factors and increasing knowledge about it can decrease the rate of preterm labor. The prevention of premature labor is better than cure. Further prospective studies with large number of patients and long-term follow-up are recommended for better understanding of the phenomenon.