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与足月婴儿相比,晚期早产儿入住新生儿重症监护病房的发生率和病因及其相关呼吸系统疾病。

Incidence and etiology of late preterm admissions to the neonatal intensive care unit and its associated respiratory morbidities when compared to term infants.

机构信息

Division of Neonatology, Department of Pediatrics, New York University School of Medicine, NY 10016, USA.

出版信息

Am J Perinatol. 2013 May;30(5):425-31. doi: 10.1055/s-0032-1326989. Epub 2012 Oct 24.

Abstract

OBJECTIVE

To determine etiology of neonatal intensive care unit (NICU) admission and acute morbidities in late preterm (LPT) neonates.

METHODS

Neonates admitted at New York University Langone Medical Center's NICU were grouped as follows: period 1: all LPT neonates with gestational age between 34(0)/(7) and 36(6)/(7) weeks and born between January 2006 and June 2007; period 2: all term neonates born between January 2007 and June 2008. Neonatal and maternal data were collected from both the groups and compared.

RESULTS

Thirty-three percent of LPT births were admitted to the NICU, compared with 7% of term births (p < 0.05). LPT neonates had an increased incidence of low birth weight, hypoglycemia, hypothermia, and hyperbilirubinemia as an admission diagnosis (p < 0.001). The overall incidence of respiratory distress syndrome (RDS) was 9%, 4%, 3%, 0.7%, 0.2% and 0% in 34-week, 35-week, 36-week, 37-week, 38- to 39-week, and 40-week gestational age neonates (p < 0. 001).There was an increased incidence of RDS and persistent pulmonary hypertension, along with an increased need for surfactant replacement therapy, continuous positive airway pressure, and ventilator support in the LPT group when compared with the term neonates (p < 0.001).

CONCLUSIONS

LPT neonates are at increased risk for hypothermia, hypoglycemia, hyperbilirubinemia, and respiratory morbidity requiring increased respiratory support when compared with term neonates.

摘要

目的

确定新生儿重症监护病房(NICU)收治早产儿和晚期早产儿(LPT)的病因和急性并发症。

方法

将纽约大学朗格尼医学中心 NICU 收治的新生儿分为以下两组:第 1 期:所有胎龄为 34(0)/(7)至 36(6)/(7)周之间、2006 年 1 月至 2007 年 6 月间出生的 LPT 新生儿;第 2 期:所有 2007 年 1 月至 2008 年 6 月间出生的足月儿。收集两组新生儿和产妇的数据并进行比较。

结果

LPT 分娩中有 33%的新生儿入住 NICU,而足月儿的这一比例为 7%(p < 0.05)。LPT 新生儿出生时低体重、低血糖、低体温和高胆红素血症的发生率更高(p < 0.001)。34 周、35 周、36 周、37 周、38 至 39 周和 40 周胎龄新生儿呼吸窘迫综合征(RDS)的总发生率分别为 9%、4%、3%、0.7%、0.2%和 0%(p < 0.001)。与足月儿相比,LPT 组 RDS 和持续性肺动脉高压的发生率增加,需要表面活性物质替代治疗、持续气道正压通气和呼吸机支持的比例也增加(p < 0.001)。

结论

与足月儿相比,LPT 新生儿更易出现低体温、低血糖、高胆红素血症和需要更多呼吸支持的呼吸系统并发症。

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