Pulver Laurie S, Denney Jeffrey M, Silver Robert M, Young Paul C
University of Utah, Salt Lake City, USA.
Clin Pediatr (Phila). 2010 Nov;49(11):1061-7. doi: 10.1177/0009922810376821. Epub 2010 Aug 19.
Late preterm newborns (LPNs), those with gestational ages (GAs) between 34 weeks and 36 weeks 6 days, account for 70% of preterm births. Because they have a mature appearance and are often cared for in a well baby nursery (WBN), parents may anticipate that the nursery course will be similar to that of a term infant and that their newborn will be discharged with his/her mother. How frequently their hospitalizations are prolonged beyond that of their mothers and the morbidities associated with prolonged hospitalization (PH) have not been well described. The objectives of the study were to (1) determine the proportion of LPNs with a PH and (2) describe the most common morbidities in LPNs and identify those associated with PH. The authors conducted retrospective chart reviews of the neonatal courses of LPNs born between December 2002 and April 2007 at the University of Utah Hospital. They compared maternal and newborn discharge dates to determine the proportion of LPNs with a PH and calculated frequencies of conditions and interventions indicating morbidity and identified associations between each of the conditions/interventions and PH. Of 235 LPNs, 94 (40%) had a PH; 75% of 34-week LPNs had a PH compared with 50% of those with GAs of 35 weeks and 25% of those with GAs of 36 weeks. The most common conditions/interventions were an oxygen need, phototherapy for jaundice, and hypothermia requiring an isolette. A need for nasogastric feeding and antibiotic administration for >3 days was consistently associated with a PH. LPNs whose only intervention was phototherapy for jaundice or IV antibiotics for <3 days did not have a PH. As a group, two thirds of LPNs experienced one or more conditions/interventions indicating morbidity, and 40% had a PH. Both were much more common in LPNs with GAs of 34 weeks compared with LPNs with GAs of 36 weeks. Nursery clinicians should counsel parents of LPNs regarding the likely possibility of morbidity and PH.
晚期早产儿（LPNs）是指胎龄（GAs）在34周零0天至36周零6天之间的新生儿，占早产的70%。由于他们外观成熟，常被安置在健康婴儿护理室（WBN）中护理，父母可能会预期其在护理室的过程与足月儿相似，并且他们的新生儿会与母亲一同出院。然而，他们住院时间超过母亲的频率以及与延长住院时间（PH）相关的发病率尚未得到充分描述。本研究的目的是：（1）确定发生PH的LPNs比例；（2）描述LPNs中最常见的疾病，并确定与PH相关的疾病。作者对2002年12月至2007年4月在犹他大学医院出生的LPNs的新生儿病程进行了回顾性病历审查。他们比较了母亲和新生儿的出院日期，以确定发生PH的LPNs比例，并计算了表明发病的病症和干预措施的频率，还确定了每种病症/干预措施与PH之间的关联。在235名LPNs中，94名（40%）发生了PH；34周的LPNs中有75%发生了PH，而胎龄35周的LPNs中这一比例为50%，胎龄36周的LPNs中为25%。最常见的病症/干预措施是需要吸氧、因黄疸进行光疗以及因体温过低需要放入暖箱。需要鼻饲喂养以及使用抗生素超过3天一直与PH相关。仅因黄疸进行光疗或静脉使用抗生素少于3天的LPNs未发生PH。总体而言，三分之二的LPNs经历了一种或多种表明发病的病症/干预措施，40%发生了PH。与胎龄36周的LPNs相比，这两种情况在胎龄34周的LPNs中更为常见。护理室临床医生应就LPNs发病和发生PH的可能性向其父母提供咨询。
