新生儿早发型败血症危险因素及维生素D水平分析

doi:10.3969/j.issn.1007-3205.2024.12.010

河北医科大学学报 ›› 2024, Vol. 45 ›› Issue (12): 1415-1419.doi: 10.3969/j.issn.1007-3205.2024.12.010

新生儿早发型败血症危险因素及维生素D水平分析

1.河北北方学院附属第二医院儿科，河北张家口 075100； 2.河北北方学院附属第二医院检验科，河北张家口 075100

出版日期:2024-12-25 发布日期:2025-01-03
作者简介:尉全平（1978-），男，河北张家口人，河北北方学院附属第二医院副主任医师，医学硕士，从事儿科疾病诊治研究。
基金资助:
张家口市市级科技计划财政资助项目（1911022D）

Analysis of risk factors and vitamin D levels of neonatal early-onset sepsis

1.Department of Pediatrics, the Second Affiliated Hospital of Hebei North University, Zhangjiakou 075100, China; 2.Department of Laboratory Medicine, the Second Affiliated Hospital of Hebei North University, Zhangjiakou 075100, China

Online:2024-12-25 Published:2025-01-03

摘要/Abstract

摘要： 目的探讨新生儿早发型败血症（early-onset sepsis，EOS）的危险因素以及和维生素D水平的关系。
方法选取河北北方学院附属第二医院收治的56例EOS新生儿为EOS组，选取同一时期出生并排除感染的新生儿60例为对照组。收集2组新生儿及对应母亲临床资料，检测2组新生儿及母亲静脉血25-羟基维生素D［25-hydroxyvitamin D,25-(OH)D］水平，对2组临床资料及维生素D水平进行分析。
结果 EOS组母亲绒毛膜羊膜炎、胎膜早破≥18 h、胎盘早剥、羊水胎粪污染、宫内窘迫、出生时窒息发生率高于对照组（P＜0.05），EOS组母亲及新生儿25-(OH)D水平显著低于对照组（P＜0.01）。多因素Logistic回归分析结果显示，母亲绒毛膜羊膜炎、胎膜早破≥18 h、新生儿出生时窒息是新生儿EOS的危险因素（P＜0.05），新生儿25-(OH)D水平是新生儿EOS的保护因素（P＜0.05）。新生儿25-(OH)D水平预测EOS的受试者工作特征曲线下面积为0.833（P=0.013），约登指数为0.512，新生儿25-(OH)D水平截断值为21.29 nmol/L，预测EOS的敏感度为83.3%，特异度为67.9%。EOS组和对照组母亲和新生儿25-(OH)D水平均呈正相关（P＜0.05）。
结论母亲绒毛膜羊膜炎、胎膜早破≥18 h、新生儿出生时窒息是EOS的危险因素，新生儿维生素D水平是EOS的保护因素，也是良好的预测指标。孕妇需重视维生素D补充，降低EOS的发病率，早期识别危险因素并检测维生素D水平有助于全面评估EOS的发病风险。

关键词: 新生儿败血症, 维生素D, 影响因素分析

Abstract: Objective To investigate the risk factors of early-onset sepsis (EOS) in neonates and its relationship with vitamin D levels.
Methods A total of 56 neonates with EOS admitted to the Second Affiliated Hospital of Hebei North University were selected as the EOS group, and another 60 neonates born in the same period excluding infections were selected as the control group. The clinical data of neonates and corresponding mothers in the two groups were collected, and the levels of 25-hydroxyvitamin D ［25-(OH)D］ in venous blood of neonates and mothers in the two groups were detected. The clinical data and vitamin D levels in the two groups were analyzed.
Results The incidences of maternal chorioamnionitis, premature rupture of membranes≥18 h, placental abruption, meconium-stained amniotic fluid, fetal distress and asphyxia at birth in EOS group were higher than those in the control group (P＜0.05). The levels of 25-(OH)D of mothers and neonates in EOS group were significantly lower than those in the control group (P＜0.01). Multivariate Logistic regression analysis showed that maternal chorioamnionitis, premature rupture of membranes≥18 h and neonatal asphyxia at birth were risk factors for EOS (P＜0.05). Neonatal 25-(OH)D level was a protective factor for EOS (P＜0.05). The area under the receiver operating characteristic curve (AUC) of neonatal 25-(OH)D level for the prediction of EOS was 0.833 (P=0.013), and the Jordan index was 0.512. The cut-off value of neonatal 25-(OH)D level was 21.29 nmol/L, and the sensitivity and specificity for the prediction of EOS were 83.3% and 67.9% respectively. The levels of 25-(OH)D in mothers and neonates were positively correlated in both EOS group and control group (P＜0.05).
Conclusion Maternal chorioamnionitis, premature rupture of membranes≥18 h and neonatal asphyxia at birth are risk factors for EOS, while neonatal 25-(OH)D level is a protective factor for EOS and also a good predictive index. Pregnant women should pay attention to vitamin D supplementation to reduce the incidence rate of EOS. Early identification of risk factors and detection of vitamin D levels is helpful for comprehensively assessing the risk of EOS.

Key words: neonatal sepsis, vitamin D, influencing factor analysis

尉全平1, 付晓康1, 苏琴1, 侯凤香1, 杨建宝2, 翟洪然1. 新生儿早发型败血症危险因素及维生素D水平分析 [J]. 河北医科大学学报, 2024, 45(12): 1415-1419.

YU Quan-ping1, FU Xiao-kang1, SU Qin1, HOU Feng-xiang1, YANG Jian-bao2, ZHAI Hong-ran1. Analysis of risk factors and vitamin D levels of neonatal early-onset sepsis [J]. Journal of Hebei Medical University, 2024, 45(12): 1415-1419.

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新生儿早发型败血症危险因素及维生素D水平分析

Analysis of risk factors and vitamin D levels of neonatal early-onset sepsis

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