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[一组极早产儿支气管肺发育不良的患病率、严重程度及预测因素]

[Prevalence, severity, and predictors of bronchopulmonary dysplasia in a cohort of very preterm infants].

作者信息

Richard M, Ramful D, Robillard P-Y, Mussard C, Loumouamou Y, Ogier M, Tasset C, N'guyen A-D, Alessandri J-L, Sampériz S, Gérardin P

机构信息

Service de réanimation néonatale et pédiatrique, pôle Femme-Mère-Enfant, groupe hospitalier Sud-Réunion, centre hospitalier universitaire de Saint-Pierre, BP 350, 97448 Saint-Pierre cedex, Réunion.

出版信息

Arch Pediatr. 2013 Sep;20(9):928-37. doi: 10.1016/j.arcped.2013.05.002. Epub 2013 Jul 2.

Abstract

OBJECTIVES

The aim of this retrospective cohort study was to determine the prevalence and severity of BPD and its predictors in a regional cohort of very preterm (VP) infants in Reunion Island.

METHODS

All autochthonous VP infants, live-born before the 33rd week of gestation (WG) between 1st January 2008 and 31st December 2009, were eligible for the study. Only VP infants surviving at least 28 days, for whom the parameters were known from birth, were included in the case-control study of predictors of moderate to severe BPD (BPDmo/s).

RESULTS

In VP infants less than 33 WG, the rate of overall BPD (3 grades of severity) was 30.7%. Among those who survived 28 days or more, the rate of BPDmo/s was 13.1% (95%CI: 10.2-15.9%). In VP infants less than 32 WG that survived at 36 WG, the prevalence of BPDmo/s was 18.2% (95% CI: 14.2-22.1%). In a fixed-effect logistic model, adjusted for gestational age, postnatal growth, and the mode of ventilation at 24h, 4 key factors were predictive of BDPmo/s: small for gestational age, surfactant, delayed energy intake, and late-onset neonatal infection. In a mixed-effect logistic model adjusted for these same cofactors, the site was associated with BPDmo/s, in line with a center-effect.

CONCLUSION

The prevalence of BPDmo/s in the mixed-race population of Reunion Island is consistent with those observed in Europe but were site-specific. In our setting, predictors of individual BPDmo/s are similar to those already identified.

摘要

目的

这项回顾性队列研究的目的是确定留尼汪岛一个地区性极早产儿(VP)队列中支气管肺发育不良(BPD)的患病率、严重程度及其预测因素。

方法

所有在2008年1月1日至2009年12月31日期间妊娠33周前出生的本地活产VP婴儿均符合研究条件。只有至少存活28天且出生时参数已知的VP婴儿被纳入中重度BPD(BPDmo/s)预测因素的病例对照研究。

结果

在妊娠33周前的VP婴儿中,总体BPD(3级严重程度)发生率为30.7%。在存活28天及以上的婴儿中,BPDmo/s发生率为13.1%(95%CI:10.2 - 15.9%)。在妊娠32周前出生且在36周龄时存活的VP婴儿中,BPDmo/s患病率为18.2%(95%CI:14.2 - 22.1%)。在固定效应逻辑模型中,经调整胎龄、出生后生长情况和24小时通气模式后,4个关键因素可预测BDPmo/s:小于胎龄、表面活性剂、能量摄入延迟和晚发性新生儿感染。在针对这些相同协变量进行调整的混合效应逻辑模型中,地点与BPDmo/s相关,符合中心效应。

结论

留尼汪岛混血人群中BPDmo/s的患病率与欧洲观察到的一致,但具有地点特异性。在我们的研究中,个体BPDmo/s的预测因素与已确定的相似。

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