孕龄小于26周新生儿的死亡率和发病率（1998 - 2003年）。一项基于人群的研究。

Mortality and morbidity of neonates born at <26 weeks of gestation (1998-2003). A population-based study.

作者信息

Landmann Eva, Misselwitz Björn, Steiss Jens O, Gortner Ludwig

机构信息

Pediatric Center, Department of Pediatrics and Neonatology, Giessen, Germany.

出版信息

J Perinat Med. 2008;36(2):168-74. doi: 10.1515/JPM.2008.016.

DOI:10.1515/JPM.2008.016

PMID:18257656

Abstract

OBJECTIVE

To describe mortality and morbidity of neonates born at <26 weeks' gestation in a contemporary population-based cohort.

METHODS

We analyzed data of neonates born at <26 weeks between 1998 and 2003 in the Federal State of Hesse, Germany. Survival was calculated at 28 days and at discharge from hospital.

RESULTS

Out of a total of 800 births, 572 infants were liveborn. Among those admitted for neonatal intensive care, 62.3% survived until day 28. Among the neonates followed until death or discharge, 59.6% were discharged home. Logistic regression analyses showed the following variables to be associated with an increased risk of death: Twins (Odds Ratio (OR) 3.7; 95% Confidence Interval (CI) 1.34-10.26), multiple birth >or=3 (OR 8.14; CI 1.23-53.86), intraventricular hemorrhage (IVH) >or=grade III (OR 4.79; CI 1.89-12.14), clinical risk index for babies score >15 (OR 2.9; CI 1.09-7.76), and a gestational age <or=23 weeks (OR 5.34; CI 1.24-22.98). Among infants discharged home, bronchopulmonary dysplasia was diagnosed in 52.2%, IVH >or=grade III and/or periventricular leukomalacia in 15%, and severe retinopathy of prematurity in 29.8%.

CONCLUSIONS

This study provides outcome data derived from a contemporary population-based cohort. Mortality and complication rates remain high.

摘要

目的

描述当代基于人群队列中孕龄小于26周出生的新生儿的死亡率和发病率。

方法

我们分析了1998年至2003年在德国黑森州出生的孕龄小于26周的新生儿数据。计算28天及出院时的存活率。

结果

在总共800例出生中，572例为活产。在入住新生儿重症监护病房的婴儿中，62.3%存活至28天。在随访至死亡或出院的新生儿中，59.6%出院回家。逻辑回归分析显示以下变量与死亡风险增加相关：双胞胎（比值比（OR）3.7；95%置信区间（CI）1.34 - 10.26）、多胎妊娠≥3胎（OR 8.14；CI 1.23 - 53.86）、脑室内出血（IVH）≥Ⅲ级（OR 4.79；CI 1.89 - 12.14）、婴儿临床风险指数评分>15（OR 2.9；CI 1.09 - 7.76）以及孕龄≤23周（OR 5.34；CI 1.24 - 22.98）。在出院回家的婴儿中，52.2%被诊断为支气管肺发育不良，15%为IVH≥Ⅲ级和/或脑室周围白质软化，29.8%为重度早产儿视网膜病变。