Bassil Kate L, Shah Prakesh S, Shah Vibhuti, Ye Xiang Y, Lee Shoo K, Jefferies Ann L
Maternal-Infant Care Research Centre (MiCare), Mount Sinai Hospital, Toronto, Ontario, Canada.
Department of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada.
Am J Perinatol. 2014 Apr;31(4):269-78. doi: 10.1055/s-0033-1347364. Epub 2013 May 31.
To examine the short-term morbidities, mortality, and use of neonatal intensive care unit (NICU) resources for late preterm, early term, and term infants.
Infants born between 34 and 40 weeks of gestation and admitted to a Canadian NICU in 2010 were designated late preterm (340/7 to 366/7 weeks), early term (370/7 to 386/7 weeks), or term (390/7 to 406/7 weeks). Mortality, short-term morbidities, and resource utilization were compared between the three groups using chi-square tests and analysis of variance.
Among 6,636 included infants, 44.2% (n = 2,935) were late preterm, 26.2% (n = 1,737) early term, and 29.6% (n = 1,964) term. Term infants were more likely to require resuscitation at birth and had lower Apgar scores than late preterm and early term infants (p < 0.001). Length of stay and need for respiratory support decreased with increasing gestational age; however, the proportion of hospital days that intensive care was required increased.
The greatest impact of late preterm infants is on NICU bed occupancy, whereas for term infants it is on intensity of care. Early term infants experience greater rates of some complications than term, demonstrating that risk persists for these infants. These findings have important implications for NICU resource planning and practice.
研究晚期早产儿、早期足月儿和足月儿的短期发病率、死亡率以及新生儿重症监护病房（NICU）资源的使用情况。
将2010年在加拿大NICU住院的孕34至40周出生的婴儿分为晚期早产儿（34⁰/₇至36⁶/₇周）、早期足月儿（37⁰/₇至38⁶/₇周）或足月儿（39⁰/₇至40⁶/₇周）。使用卡方检验和方差分析比较三组之间的死亡率、短期发病率和资源利用情况。
在纳入研究的6636例婴儿中，44.2%（n = 2935）为晚期早产儿，26.2%（n = 1737）为早期足月儿，29.6%（n = 1964）为足月儿。足月儿出生时更有可能需要复苏，且阿氏评分低于晚期早产儿和早期足月儿（p < 0.001）。住院时间和呼吸支持需求随胎龄增加而减少；然而，需要重症监护的住院天数比例增加。
晚期早产儿对NICU床位占用影响最大，而足月儿对护理强度影响最大。早期足月儿某些并发症的发生率高于足月儿，表明这些婴儿仍存在风险。这些发现对NICU资源规划和实践具有重要意义。
