早产儿与足月儿心律失常的危险因素、临床特征及预后分析OA

Objective To analyze the risk factors,clinical characteristics,treatment outcomes and prog-nosis differences of arrhythmia in premature and term infants.Methods A retrospective analysis was conduc-ted on the clinical data of 211 neonates with arrhythmia who were hospitalized in the Pediatrics and Neonatal Intensive Care Unit of Affiliated Hospital of Jining Medical University from December 2014 to December 2024.The neonates were divided into the term group(gestational age≥37 weeks,n=130)and the premature group(gestational age<37 weeks,n=81).The clinical characteristics,risk factors for arrhythmia,treatment outcomes and prognosis differences between the two groups were compared.Results Compared with the term group,the premature group had higher incidences of maternal hypertension/preeclampsia during pregnancy(13.6%vs.5.4%)and placental abruption(7.4%vs.0.8%),and an earlier onset age[1(1,2)d vs.2(1,4)d].However,the premature group had lower proportions of abnormal creatine kinase(CK,35.8%vs.59.2%),unknown etiology(11.1%vs.51.5%),combined≥2 etiologies(1.2%vs.7.7%),and arrhythmia on physi-cal examination(13.6%vs.41.5%).Conversely,the proportions of electrolyte disorders(39.5%vs.10.0%),perinatal asphyxia and hypoxia(32.1%vs.10.0%),and abnormal electrocardiographic monitoring(35.8%vs.12.3%)were higher in the premature group.The differences were statistically significant(P<0.05).Binary logistic regression analysis showed that birth weight(OR=0.039,95%CI:0.015-0.104)and perinatal asphyxia and hypoxia(OR=6.154,95%CI:1.649-22.970)were independent influencing factors for arrhythmia in premature infants(P<0.05).Regarding arrhythmia types,ectopic beats were the most common(48.8%),followed by tachycardia(24.6%),with no statistically significant difference in the distri-bution of arrhythmia types between the two groups(P>0.05).The overall cure and improvement rate was 83.9%,and 15 children(7.1%)died due to progression of the primary disease.Conclusion Premature infants are more prone to arrhythmia,which is related to perinatal asphyxia and hypoxia,good perinatal care may help improve their prognosis;while term infants have more concealed causes,and may be more related to genetic factors.