Department of Obstetrics and Gynaecology, University Medical Centre, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
Neonatology. 2010;98(3):278-88. doi: 10.1159/000285715. Epub 2010 May 7.
Improvement in perinatal and neonatal care has resulted in increased survival of extremely low birth weight (ELBW) infants.
To describe survival and neonatal morbidity in a cohort of ELBW infants, to compare two consecutive 5-year periods, and compare appropriate (AGA) with small for gestational age (SGA) infants (AGA ≥p10, and SGA <p10).
Retrospective cohort study of 179 live-born infants with a birth weight (BW) of ≤750 g and gestation of ≥24 weeks, born in 1996-2000 (cohort I, n = 94) and 2001-2005 (cohort II, n = 85) in the Wilhelmina Children's Hospital Utrecht, the Netherlands.
During NICU stay (n = 146) 62.3% experienced infant respiratory distress syndrome (IRDS), 46.6% bronchopulmonary dysplasia, 50.7% septicemia, 34.2% periventricular leukomalacia grade I and 24.7% intraventricular hemorrhage grade I/II. IRDS grade III/IV occurred significantly more often in cohort I (p = 0.042), whereas septicemia and hyperbilirubinemia occurred more in cohort II (p = 0.045 and p = 0.001). In AGA infants mean gestation was significantly shorter (p < 0.001), and IRDS grade III/IV (p = 0.015), mechanical ventilation (p = 0.045) and patent ductus arteriosus (p = 0.003) were significantly more prevalent. Overall survival was 62%, and survival in the NICU increased from 65.8% (cohort I) to 88.1% (cohort II, p = 0.002). Survival of AGA and SGA infants did not differ, but increased with time (71.4 to 75.9% and 61.4 to 97.4%, respectively).
Mortality of infants with a BW of ≤750 g is high, but decreased over time, especially in SGA infants. Considerable neonatal morbidity was present, especially in AGA infants, most likely due to their significantly shorter gestation.
围产期和新生儿护理的改善导致极低出生体重（ELBW）婴儿的存活率提高。
描述 ELBW 婴儿的存活率和新生儿发病率，比较两个连续的 5 年期间，并比较适当（AGA）和小于胎龄（SGA）婴儿（AGA≥p10 和 SGA<p10）。
回顾性队列研究 1996-2000 年（队列 I，n=94）和 2001-2005 年（队列 II，n=85）在荷兰乌得勒支威廉明娜儿童医院出生体重（BW）≤750g 且胎龄≥24 周的 179 例活产婴儿。
在新生儿重症监护病房（NICU）住院期间（n=146），62.3%的婴儿患有呼吸窘迫综合征（IRDS），46.6%患有支气管肺发育不良，50.7%患有败血症，34.2%患有 1 级脑室周围白质软化症，24.7%患有 1/2 级脑室内出血。IRDS 级 III/IV 在队列 I 中更为常见（p=0.042），而败血症和高胆红素血症在队列 II 中更为常见（p=0.045 和 p=0.001）。AGA 婴儿的平均胎龄明显较短（p<0.001），IRDS 级 III/IV（p=0.015）、机械通气（p=0.045）和动脉导管未闭（p=0.003）更为常见。总体存活率为 62%，NICU 存活率从队列 I 的 65.8%增加到队列 II 的 88.1%（p=0.002）。AGA 和 SGA 婴儿的存活率没有差异，但随时间增加（分别为 71.4%至 75.9%和 61.4%至 97.4%）。
BW≤750g 的婴儿死亡率较高，但随时间减少，尤其是 SGA 婴儿。存在相当大的新生儿发病率，尤其是 AGA 婴儿，这很可能是由于他们的胎龄明显较短。
