晚早产儿先天性心脏病结局：双重危害？

Outcomes of congenital heart disease in late preterm infants: double jeopardy?

机构信息

Department of Pediatrics, Wayne State University, Children's Hospital of Michigan, Detroit, MI 48201, USA.

出版信息

Acta Paediatr. 2011 Aug;100(8):1104-7. doi: 10.1111/j.1651-2227.2011.02245.x. Epub 2011 Mar 24.

DOI:10.1111/j.1651-2227.2011.02245.x

PMID:21362036

Abstract

AIM

To evaluate outcomes of late preterm (34-36 6/7 weeks gestation) infants with congenital heart defects requiring surgical intervention during initial admission (added), in comparison with term (37-42 weeks) controls.

METHODS

This was a retrospective chart review of consecutive late preterm and term infants with congenital heart lesions, requiring surgical intervention during initial admission.

RESULTS

Our cohort (n=88) comprised 26 late preterm infants (group 1) and 62 term controls (group 2). The two groups differed significantly in mean (SD) gestation [34.5 (1.5) vs. 39.1 (1) weeks)], birth weight [2335 (402) vs. 3173 (401) g] and weight [2602 (739) vs. 3273 (507) g] and age [33 (51) vs. 11 (14) days] at surgery. Cardiac diagnosis frequencies were similar in both groups. The mean (SD) duration of PGE1 [31.9 (56.8) vs. 11.3 (24.9) days] and need for preoperative pressors (25% vs. 8%) were significantly higher in group 1. Death (23% vs. 8%, p=0.05) tended to be higher in group 1. Rates of necrotizing enterocolitis (23% vs. 1.7%), seizures (19% vs. 0%), oxygen need (12% vs. 0%) and gavage feeds (12% vs. 1.6%) at discharge were all significantly higher in the late preterm cohort.

CONCLUSIONS

These data highlight the extreme vulnerability of infants with the 'double hits' of prematurity and heart defects.

摘要

目的

评估在初始住院期间（附加）需要手术干预的患有先天性心脏病的晚期早产儿（34-36 6/7 周）的结局，并与足月（37-42 周）对照组进行比较。

方法

这是一项回顾性连续病例研究，纳入了在初始住院期间需要手术干预的患有先天性心脏病变的晚期早产儿和足月婴儿。

结果

我们的队列（n=88）包括 26 名晚期早产儿（第 1 组）和 62 名足月对照组（第 2 组）。两组在平均（标准差）胎龄[34.5（1.5）与 39.1（1）周]、出生体重[2335（402）与 3173（401）g]和体重[2602（739）与 3273（507）g]以及手术时的年龄[33（51）与 11（14）天]方面存在显著差异。两组的心脏诊断频率相似。第 1 组的 PGE1 平均（标准差）持续时间[31.9（56.8）与 11.3（24.9）天]和术前升压药的需求（25%与 8%）显著更高。第 1 组的死亡率（23%与 8%，p=0.05）也偏高。第 1 组的坏死性小肠结肠炎发生率（23%与 1.7%）、癫痫发作率（19%与 0%）、氧气需求率（12%与 0%）和管饲喂养率（12%与 1.6%）均显著更高。