Division of Neonatal-Perinatal Medicine, Department of Pediatrics, IWK Health Centre, Dalhousie University, Halifax, Nova Scotia, Canada.
Pediatrics. 2010 Dec;126(6):e1538-44. doi: 10.1542/peds.2010-1167. Epub 2010 Nov 15.
To retrospectively review changes in the causes of death of infants dying in the NICU at Canada's largest outborn pediatric center.
All inpatient deaths at the Hospital for Sick Children's NICU that occurred in the years 1997, 2002, and 2007 were retrospectively reviewed to identify the primary cause of death. Classification of the cause of death was based on a modified version of the Perinatal Society of Australia and New Zealand's Neonatal Death Classification.
The annual mortality rate remained relatively constant (average of 7.6 deaths per 100 admissions between 1988 and 2007). A total of 156 deaths were analyzed: 53 in 1997; 50 in 2002; and 53 in 2007. The chronological age at which premature infants died increased significantly over the 3 time periods (P = .01). The proportion of deaths attributable to extreme prematurity and intraventricular hemorrhage decreased over the study period, whereas the proportion of deaths attributed to gastrointestinal causes (specifically necrotizing enterocolitis and focal intestinal perforation) increased. The proportion of infants for whom there was a decision to limit care before death was stable at between 83% and 92%.
A larger proportion of outborn premature infants admitted to the Hospital for Sick Children's NICU seem to be surviving the early problems of prematurity only to succumb to late complications.
回顾加拿大最大的外地产儿科中心新生儿重症监护病房（NICU）中死亡婴儿死因的变化。
回顾了 Sick Kids 医院 NICU 在 1997 年、2002 年和 2007 年期间所有住院死亡的病例，以确定主要死因。死因分类基于澳大利亚和新西兰围产期协会新生儿死亡分类的修订版。
年死亡率保持相对稳定（1988 年至 2007 年期间每 100 例住院死亡平均为 7.6 例）。共分析了 156 例死亡病例：1997 年 53 例；2002 年 50 例；2007 年 53 例。早产儿死亡的时间年龄在三个时期显著增加（P =.01）。由于极早产和脑室内出血导致的死亡比例在研究期间有所下降，而由于胃肠道原因（特别是坏死性小肠结肠炎和局灶性肠穿孔）导致的死亡比例有所增加。在死亡前决定限制治疗的婴儿比例在 83%至 92%之间保持稳定。
越来越多的外地产前早产儿似乎能够在 NICU 存活下来，仅能克服晚期并发症。
