极低出生体重儿死亡和脑损伤的产科因素。

Obstetrical factors for death and brain injury among extremely-low-birth-weight infants.

作者信息

Fukami Tatsuya, Yoshizato Toshiyuki, Mori Toshiko, Yukitake Ko, Miyake Yoshihiro, Kawarabayashi Tatsuhiko

机构信息

Department of Obstetrics and Gynecology, School of Medicine, Fukuoka University, Fukuoka, Japan.

出版信息

J Perinat Med. 2007;35(6):543-9. doi: 10.1515/JPM.2007.111.

DOI:10.1515/JPM.2007.111

PMID:18052840

Abstract

OBJECTIVE

To examine the obstetrical risk factors for death and brain injury among extremely-low-birth-weight (ELBW) infants (birth weight <1000 g).

STUDY DESIGN

Study subjects were 121 ELBW infants born at a single tertiary perinatal center. Death among ELBW infants was considered to have occurred when subjects died within their corrected age of 40 weeks. In the sub-analysis of the 91 ELBW infants who survived their corrected age of 40 weeks, brain injury was defined as present when criteria based on ultrasound and/or MRI were substantiated.

RESULTS

A birth weight of <800 g [adjusted odds ratio (OR), 14.57; 95% confidence interval (CI), 4.72-56.98], a younger gestational age of <26 weeks (adjusted OR, 4.64; 95% CI, 1.60-14.90), and a low Apgar score of <5 (adjusted OR, 3.88; 95% CI, 1.32-12.45) were significantly associated with death among ELBW infants. A maternal age of 30 years or older (adjusted OR, 3.71; 95% CI, 1.19-13.35) was only associated with brain injury among surviving ELBW infants.

CONCLUSION

Obstetrical care should be aimed at preventing or predicting premature delivery especially at <26 weeks of gestation.

摘要

目的

研究极低出生体重（ELBW，出生体重<1000g）婴儿死亡和脑损伤的产科危险因素。

研究设计

研究对象为在一家三级围产期中心出生的121例ELBW婴儿。ELBW婴儿在矫正年龄40周内死亡被视为发生了死亡。在对91例矫正年龄40周后存活的ELBW婴儿进行的亚分析中，当基于超声和/或MRI的标准得到证实时，脑损伤被定义为存在。

结果

出生体重<800g（调整优势比[OR]，14.57；95%置信区间[CI]，4.72 - 56.98）、胎龄<26周（调整OR，4.64；95%CI，1.60 - 14.90）以及阿氏评分<5分（调整OR，3.88；95%CI，1.32 - 12.45）与ELBW婴儿死亡显著相关。母亲年龄30岁及以上（调整OR，3.71；95%CI，1.19 - 13.35）仅与存活的ELBW婴儿脑损伤相关。