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[孕32周0天至36周6天出生的中度早产儿的临床和经济挑战]

[Clinical and economic challenges of moderate preterm babies born between 32+0 and 36+6 weeks of gestation].

作者信息

Steetskamp J, Puhl A G, Zelazny J, Skala C, Kölbl H, Bahlmann F

机构信息

Universitätsmedizin Mainz, Klinik und Poliklinik für Geburtshilfe und Frauenheilkunde, Germany.

出版信息

Z Geburtshilfe Neonatol. 2011 Aug;215(4):158-62. doi: 10.1055/s-0031-1275740. Epub 2011 Aug 26.

Abstract

BACKGROUND

Preterm births show a worldwide increasing incidence. The majority of preterm births occur between 32+0 and 36+6 weeks of gestation and are associated with an increased rate of maternal and neonatal morbidity. The focus of our research is the clinical and economical analysis of all preterm births between 32+0 and 36+6 weeks of gestation in a German level 1 perinatal centre over a period of 3 years.

MATERIALS AND METHODS

A retrospective analysis of all preterm births between 32+0 and 36+6 weeks of gestation in the University Hospital Mainz from 2007 to 2009 was undertaken. Data were collected using our electronic documentation system. Gestational age at delivery, mode of birth, indication for delivery, duration of the peripartum treatment, treatment of the newborn in the children's hospital, birth weight and therapy costs were evaluated.

RESULTS

We recorded 407 moderate preterm births in total; this amounts to a rate of of 10% of all births. Major causes of prematurity were PPROM, preterm labour and preeclampsia/HELLP. Maternal and fetal systemic diseases were more uncommon. Rates of Caesarean sections (62%) and of neonatal inpatient treatment needs (58.5%) were high. Maternal treatment costs were 332 Euro/day. The mean duration of maternal inpatient treatment was 13.15 days.

DISCUSSION

Moderate preterm birth is associated with maternal morbidity frequently due to a high rate of Caesarean sections. Neonatal morbidity is also increased. In comparison with previous research, we saw an increased rate of pregnancy complications. This could be typical for a level 1 perinatal centre. Moderate preterm birth is seen as the cause of considerable treatment costs.

摘要

背景

早产在全球范围内的发病率呈上升趋势。大多数早产发生在妊娠32⁺⁰至36⁺⁶周之间,且与孕产妇和新生儿发病率的增加相关。我们研究的重点是对德国一家一级围产期中心3年内妊娠32⁺⁰至36⁺⁶周之间的所有早产进行临床和经济学分析。

材料与方法

对美因茨大学医院2007年至2009年期间妊娠32⁺⁰至36⁺⁶周之间的所有早产进行回顾性分析。数据通过我们的电子文档系统收集。评估了分娩时的孕周、分娩方式、分娩指征、围产期治疗时长、儿童医院对新生儿的治疗、出生体重和治疗费用。

结果

我们总共记录了407例中度早产;这占所有分娩的10%。早产的主要原因是胎膜早破、早产和子痫前期/HELLP综合征。孕产妇和胎儿的全身性疾病较为少见。剖宫产率(62%)和新生儿住院治疗需求率(58.5%)较高。孕产妇治疗费用为每天332欧元。孕产妇住院治疗的平均时长为13.15天。

讨论

中度早产常常因剖宫产率高而与孕产妇发病相关。新生儿发病率也有所增加。与之前的研究相比,我们发现妊娠并发症的发生率有所上升。这可能是一级围产期中心的典型情况。中度早产被视为产生可观治疗费用的原因。

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