Department of Neonatology, Hôpital des Enfants, Hôpitaux Universitaires de Genève, Switzerland.
Swiss Med Wkly. 2011 Jun 24;141:w13212. doi: 10.4414/smw.2011.13212. eCollection 2011.
To provide population-based, gestational age (GA) stratified incidence of mortality and morbidities.
Population-based prospective observational study of infants born between 23 0/7 and 31 6/7 weeks GA in the years 2000-2004 in all Swiss neonatal intensive care units. Outcomes measured were: mortality, severe intraventricular haemorrhage (IVH), periventricular leukomalacia (PVL), necrotizing enterocolitis (NEC), moderate/severe bronchopulmonary dysplasia (BPD) and free of major complications.
Mortality was 19% of 3083 infants. Mortality (95% CI) decreased from 95% (88%, 99%) at 23 weeks to 3% (2%, 5%) at 31 weeks. Short-term survival free of major complications was 66% (65%, 68%) overall and increased from 2%(0%, 9%) to 89% (87%, 92%). Rate of IVH was 8% (7%, 9%), PVL 2% (2%, 3%), NEC 3% (3%, 4%) and BPD 11% (10%, 12%). Males had more IVH than females (9% vs. 6%). Antenatal steroids were associated with lower mortality (11% vs. 18%) and IVH (5% vs. 12%). Odds of free of major complications (OR, 95%CI) were positive for female gender 1.2 (1.0, 1.5), steroids 1.3 (1.1, 1.5), multiple gestation 1.3 (1.0, 1.6), not small for gestational age 2.7 (2.0, 3.5), and each additional week of GA 1.6 (1.5, 1.7).
Mortality and incidence of morbidities known to influence outcome show a weekly decline with increasing gestational age, except for PVL. Gestational age stratified data are a key component for prenatal counselling.
提供基于人群的、按胎龄（GA）分层的死亡率和发病率数据。
这是一项 2000-2004 年在瑞士所有新生儿重症监护病房进行的基于人群的前瞻性观察性研究，纳入胎龄为 23 0/7 至 31 6/7 周的婴儿。测量的结果包括死亡率、严重脑室出血（IVH）、脑室周围白质软化（PVL）、坏死性小肠结肠炎（NEC）、中重度支气管肺发育不良（BPD）和无主要并发症。
3083 名婴儿的死亡率为 19%。死亡率（95%CI）从 23 周时的 95%（88%，99%）降至 31 周时的 3%（2%，5%）。短期无主要并发症的存活率总体为 66%（65%，68%），从 2%（0%，9%）增至 89%（87%，92%）。IVH 发生率为 8%（7%，9%），PVL 发生率为 2%（2%，3%），NEC 发生率为 3%（3%，4%），BPD 发生率为 11%（10%，12%）。男性 IVH 发生率高于女性（9% vs. 6%）。产前使用类固醇与死亡率（11% vs. 18%）和 IVH（5% vs. 12%）降低相关。无主要并发症的几率（OR，95%CI）与女性（1.2（1.0，1.5））、类固醇（1.3（1.1，1.5））、多胎妊娠（1.3（1.0，1.6））、非小于胎龄儿（2.7（2.0，3.5））和每增加一周 GA（1.6（1.5，1.7））呈正相关。
已知影响结局的死亡率和发病率呈每周下降趋势，与 GA 增加相关，PVL 除外。GA 分层数据是产前咨询的关键组成部分。
