Pediatrics & Neonatology Department, Isfahan University of Medical Sciences, Isfahan, Iran.
World J Pediatr. 2010 Aug;6(3):228-32. doi: 10.1007/s12519-010-0204-1. Epub 2010 Jun 12.
The outcome of preterm neonates has been varied in different hospitals and regions in developing countries. This study aimed to determine the mortality, morbidity and survival of neonates weighing 1500 g or less and with gestational age of 30 weeks or less who were admitted to referral neonatal intensive care units (NICUs) of two hospitals in Isfahan city, Iran and to investigate the effect of birth weight, gestational age and Apgar score on infant mortality.
We studied retrospectively the morbidity, mortality and survival of 194 newborns with a birth weight of </=1500 g and a gestational age of </=30 weeks who had been hospitalized during a 15-month period in NICUs of the two referral hospitals. The Kaplan-Meier method was used to estimate the survival of the neonates. The survival was defined as the discharge of live infant from the hospital within 75 days.
Overall, 125 (64.4%; 95%CI 58%-71%) of the 194 infants died during their hospital stay. The morbidity in this study was as follows: respiratory distress syndrome 76% (95%CI 70%-82%), septicemia 30.9% (95%CI 24%-37%), bronchopulmonary dysplasia 10.3% (95%CI 6%-15%), necrotizing enterocolitis 6.7% (95%CI 3%-10%), patent ductus arteriosus 12.4% (95%CI 8%-17%), intraventricular hemorrhage 7.2% (95%CI 4%-11%), and apnea 16.5% (95%CI 11%-22%). Packed cell transfusion was required in 43.3% (95%CI 36%-50%) of the neonates. The Kaplan Meier survival analysis revealed that 75% of the infants would live past 2 days, 50% after 14 days, and 25% after 69 days.
Even with modern perinatal technology and care, early deaths of very low birth weight infants are still common in our referral hospitals. The outcome of infants born at 24-28 weeks is unfavorable. The hospital level is an important factor affecting the mortality and morbidity of these infants.
在发展中国家，不同医院和地区的早产儿结局存在差异。本研究旨在确定伊朗伊斯法罕市两家转诊新生儿重症监护病房（NICU）收治的体重 1500 克或以下、胎龄 30 周或以下的新生儿的死亡率、发病率和存活率，并探讨出生体重、胎龄和阿普加评分对婴儿死亡率的影响。
我们回顾性研究了在两家转诊医院 NICU 住院的 194 名出生体重 </=1500 克和胎龄 </=30 周的新生儿在 15 个月期间的发病率、死亡率和存活率。采用 Kaplan-Meier 法估计新生儿的存活率。存活率定义为 75 天内活婴出院。
总体而言，194 名婴儿中有 125 名（64.4%；95%CI 58%-71%）在住院期间死亡。本研究的发病率如下：呼吸窘迫综合征 76%（95%CI 70%-82%）、败血症 30.9%（95%CI 24%-37%）、支气管肺发育不良 10.3%（95%CI 6%-15%）、坏死性小肠结肠炎 6.7%（95%CI 3%-10%）、动脉导管未闭 12.4%（95%CI 8%-17%）、脑室内出血 7.2%（95%CI 4%-11%）和呼吸暂停 16.5%（95%CI 11%-22%）。需要输血的新生儿有 43.3%（95%CI 36%-50%）。Kaplan-Meier 生存分析显示，75%的婴儿会在第 2 天存活，50%在第 14 天存活，25%在第 69 天存活。
即使有现代围产期技术和护理，极低出生体重儿的早期死亡在我们的转诊医院仍然很常见。24-28 周出生的婴儿预后不佳。医院级别是影响这些婴儿死亡率和发病率的重要因素。
