Trotman H, Lord C
Department of Obstetrics, Gynaecology and Child Health, The University of the West Indies, Kingston 7, Jamaica.
West Indian Med J. 2007 Oct;56(5):409-13.
To describe the early outcome of extremely low birthweight infants delivered at the University Hospital of the West Indies.
A two-year retrospective review of the charts of all live, inborn extremely low birthweight infants admitted to the neonatal unit between January 1, 2002 and December 31, 2003 was conducted Differences between survivors and non-survivors were determined using analysis of variance and predictors of outcome were determined using multiple regression models.
During the study period, 47 extremely low birthweight infants were admitted to the neonatal unit. The mean +/- SD birthweight and gestational age of these infants were 780 +/- 137 g and 27 +/- 2 weeks respectively. Twenty (43%) infants survived Babies (19; 58%) of gestational age > or = 27 weeks had increased survival compared to those < 27 weeks, (1; 7%; p = 0.001) and babies weighing > or = 750 g had increased survival (17, 65%) compared to those weighing < 750 g, (3, 14%; p < 0.001). Infants delivered by Caesarean section had improved survival 15 (58%) over those delivered vaginally (5, 24%; p = 0.02). All six (100%) infants whose mothers did not receive prenatal steroids died while 18 (50%) infants whose mothers received prenatal steroids died (p = 0.02). Significant factors associated with outcome were offered and gender was entered into a multiple regression model; gestational age and female gender remained independent predictors of survival.
Obstetric measures for the prevention of preterm delivery need to be optimized in order to decrease the morbidity and mortality associated with extremely low birthweight infants.
描述在西印度群岛大学医院分娩的极低出生体重儿的早期结局。
对2002年1月1日至2003年12月31日期间入住新生儿病房的所有存活的、本地出生的极低出生体重儿的病历进行了为期两年的回顾性研究。使用方差分析确定存活者与非存活者之间的差异,并使用多元回归模型确定结局的预测因素。
在研究期间,47名极低出生体重儿入住新生儿病房。这些婴儿的平均出生体重±标准差和胎龄分别为780±137克和27±2周。20名(43%)婴儿存活。胎龄≥27周的婴儿(19名;58%)的存活率高于胎龄<27周的婴儿(1名;7%;p = 0.001),体重≥750克的婴儿(17名,65%)的存活率高于体重<750克的婴儿(3名,14%;p<0.001)。剖宫产分娩的婴儿存活率(15名,58%)高于阴道分娩的婴儿(5名,24%;p = 0.02)。母亲未接受产前类固醇治疗的所有6名(100%)婴儿死亡,而母亲接受产前类固醇治疗的18名(50%)婴儿死亡(p = 0.02)。提供了与结局相关的重要因素,并将性别纳入多元回归模型;胎龄和女性性别仍然是存活的独立预测因素。
需要优化预防早产的产科措施,以降低与极低出生体重儿相关的发病率和死亡率。