Aly Hany, Massaro An, Acun Ceyda, Ozen Maide
Department of Neonatology, The George Washington University and the Children's National Medical Center , Washington, DC , USA.
J Matern Fetal Neonatal Med. 2014 Mar;27(4):402-6. doi: 10.3109/14767058.2013.818114. Epub 2013 Jul 24.
We aimed to compare clinical presentation and risk factors associated with the development of pneumothorax among newborns of different birth weight (BW) categories.
We collected clinical and respiratory data on all newborns diagnosed with pneumothorax over a 10-year period. Infants were classified into two groups with BW ≥ 2500 g and <2500 g.
From 13,811 infants, we identified 77 with pneumothorax (BW ≥ 2500 g in 33 and BW <2500 g in 44 infants). The prevalence of pneumothorax in the two BW categories was 0.27% and 2.5%, respectively. Infants with BW ≥ 2500 g were diagnosed with neumothorax at a median age of 5.5 h, and mostly (70%) did not require intubation. Infants with BW <2500 g were diagnosed with pneumothorax at a median age of 34 h, presenting with hypercarbia and increased requirement for supplemental oxygen. The majority of these infants (89%) received mechanical ventilation after pneumothorax. When compared to matched controls, there was a lower proportion of African-American infants in the pneumothorax group (48% versus 73%, p = 0.029) and a higher rate of bronchopulmonary dysplasia (30% versus 7%, p = 0.004).
Onset, presentation and management of pneumothorax varied according to BW. Preterm infants with pneumothorax are at increased risk for developing bronchopulmonary dysplasia.
我们旨在比较不同出生体重（BW）类别的新生儿气胸发生的临床表现及相关危险因素。
我们收集了10年间所有诊断为气胸的新生儿的临床和呼吸数据。婴儿被分为两组，BW≥2500 g和<2500 g。
在13811名婴儿中，我们确定了77例气胸患儿（33例BW≥2500 g，44例BW<2500 g）。两个BW类别中的气胸患病率分别为0.27%和2.5%。BW≥2500 g的婴儿气胸诊断中位年龄为5.5小时，大多数（70%）不需要插管。BW<2500 g的婴儿气胸诊断中位年龄为34小时，表现为高碳酸血症和对补充氧气的需求增加。这些婴儿中的大多数（89%）气胸后接受了机械通气。与匹配的对照组相比，气胸组中非裔美国婴儿的比例较低（48%对73%，p = 0.029），支气管肺发育不良的发生率较高（30%对7%，p = 0.004）。
气胸的发病、表现和处理因BW而异。气胸的早产儿发生支气管肺发育不良的风险增加。
