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目的探讨羊水胎粪污染新生儿的行为神经能力。方法选择2010年1～12月在我院产科出生、羊水胎粪污染、且母亲无妊娠合并症的足月新生儿为观察组,分为Ⅰ、Ⅱ、Ⅲ度羊水污染;选择同期出生的健康足月新生儿为对照组。新生儿出生2～3天、7～10天和26～28天分别进行新生儿20项行为神经测定(NBNA评分),比较各组NBNA评分的差异。结果Ⅰ度羊水污染新生儿(36例)出生2～3天和7～10天NBNA评分均低于对照组(280例)[(37.1±1.5)比(38.7±1.2),(38.3±1.5)比(39.1±1.4),P<0.05],26～28天与对照组比较差异无统计学意义(P>0.05);Ⅱ度羊水污染新生儿(108例)各时间段NBNA评分均低于对照组[(35.9±1.2)比(38.7±1.2),(37.0±1.3)比(39.1±1.4),(38.4±1.6)比(40.0±1.4),P分别<0.01、0.01、0.05];Ⅲ度羊水污染新生儿(161例)各时间段NBNA评分均明显低于对照组[(34.6±1.3)比(38.7±1.2),(36.2±1.6)比(39.1±1.4),(37.5±2.1)比(40.0±1.4),P均<0.01],观察组中,Ⅱ度羊水污染新生儿出生2～3天NBNA评分低于Ⅰ度羊水污染新生儿,Ⅲ度羊水污染新生儿出生2～3天和7～10天NBNA评分均低于Ⅱ度羊水污染新生儿,Ⅲ度羊水污染新生儿各时间段NBNA评分均明显低于Ⅰ度羊水污染新生儿(P均<0.05)。结论羊水胎粪污染影响新生儿行为神经能力,羊水污染程度越重,新生儿NBNA评分越低。需及时处理羊水胎粪污染,以减少围产儿的脑损伤。
Objective To investigate the behavioral neural ability of neonates with meconium-stained amniotic fluid. Methods January to December 2010 in our hospital obstetric, meconium-stained amniotic fluid, and the mother of non-pregnancy complications of full-term newborn as observation group, divided into Ⅰ, Ⅱ, Ⅲ degree of amniotic fluid contamination; choose the same period of birth health Full-term newborn as a control group. Neonatal birth 2 to 3 days, 7 to 10 days and 26 to 28 days of neonatal 20 behavioral neurological assessment (NBNA score), NBNA scores were compared between groups. Results The NBNA score of newborn infants (36 cases) with IU degree of amniotic fluid contamination at 2 to 3 days and 7 to 10 days after birth was lower than that of the control group (280 cases) [(37.1 ± 1.5) vs (38.7 ± 1.2) and (38.3 ± 1.5) (39.1 ± 1.4), P <0.05]. There was no significant difference between the control group and the control group on day 26-28 (P> 0.05). The NBNA score of neonatal second degree amniotic fluid contamination (108 cases) was lower than that of the control (35.9 ± 1.2) vs (38.7 ± 1.2), (37.0 ± 1.3) vs (39.1 ± 1.4), (38.4 ± 1.6) vs (40.0 ± 1.4), P <0.01, 0.01, The NBNA score of neonatal children with amniotic fluid contamination (161 cases) was significantly lower than that of the control group [(34.6 ± 1.3) vs (38.7 ± 1.2), (36.2 ± 1.6) vs (39.1 ± 1.4), (37.5 ± 2.1) (40.0 ± 1.4), P <0.01, respectively. In the observation group, the NBNA score of neonates with grade Ⅱ amniotic fluid 2 to 3 days after birth was lower than that of degree Ⅰ amniotic fluid, neonates with grade Ⅲ amniotic fluid contamination were 2 to 3 days and The NBNA score of 7-10 days was lower than that of grade Ⅱ amniotic fluid contamination, and the NBNA score of neonates with grade Ⅲ amniotic fluid contamination was significantly lower than that of grade Ⅰ amniotic fluid contamination (all P <0.05). Conclusion Amniotic fluid meconium contamination affects the ability of newborns with behavioral neuroimaging. The more amniotic fluid contamination, the lower the neonatal NBNA score. Need to deal with amniotic meconium in time to reduce perinatal brain damage.