Fernández Rocío, D'Apremont Ivonne, Domínguez Angélica, Tapia José L
División de Pediatría, Hospital Dr. Sótero Del Río.
Sección de Neonatología, Hospital Dr. Sótero Del Río.
Arch Argent Pediatr. 2014 Oct;112(5):405-12. doi: 10.5546/aap.2014.eng.405.
To analyze survival and relevant morbidity by gestational age (GA) in very low birth weight (VLBW) infants (<1500 g) and, based on these data, develop a fact sheet to provide information to perinatal healthcare providers and very low birth weight preterm infants' parents.
Data were prospectively collected in relation to newborn infants with a birth weight between 500 g and 1500 g admitted to 45 sites of the Neocosur Neonatal Network (Red Neonatal Neocosur) between January 2001 and December 2011.
Data on 8234 VLBW with a GA between 24+0 and 31+6 weeks were analyzed. Overall mortality was 26% (95% CI: 25.0-26.9), including 2.6% of deaths in the delivery room. Fact sheets for survival and morbidity for each week of gestation were developed based on collected data. Survival at discharge increased from 29% at 24 weeks of GA to 91% at 31 weeks of GA (p < 0.001). The incidence of relevant neonatal morbidity was inversely related to GA (p < 0.001). Overall, 30.8% had retinopathy of prematurity, 25% bronchopulmonary dysplasia, 10.9% necrotizing enterocolitis, 7.2% severe intraventricular hemorrhage, and 4.6% periventricular leukomalacia. Among survivors, 47.3% had none of these five conditions.
A tool for use in a clinical setting was developed based on updated regional data for establishing week-to-week survival and morbidity of newborn infants born between 24+0 and 31+6 weeks of GA. This information could be used to make decisions related to perinatal care and for counseling parents.
分析极低出生体重(VLBW,<1500 g)婴儿按胎龄(GA)划分的生存情况及相关发病率,并基于这些数据编制一份情况说明书,为围产期医疗保健提供者和极低出生体重早产儿的父母提供信息。
前瞻性收集了2001年1月至2011年12月期间在新南方共同市场新生儿网络(新南方共同市场新生儿网络)45个站点收治的出生体重在500 g至1500 g之间的新生儿的数据。
分析了8234例胎龄在24⁺⁰至31⁺⁶周之间的极低出生体重儿的数据。总体死亡率为26%(95%可信区间:25.0 - 26.9),其中产房内死亡占2.6%。根据收集的数据编制了各孕周生存和发病情况说明书。出院时的生存率从孕24周时的29%升至孕31周时的91%(p < 0.001)。相关新生儿发病率与胎龄呈负相关(p < 0.001)。总体而言,30.8%发生早产儿视网膜病变,25%发生支气管肺发育不良,10.9%发生坏死性小肠结肠炎,7.2%发生重度脑室内出血,4.6%发生脑室周围白质软化。在存活者中,47.3%未出现这五种情况中的任何一种。
基于最新的区域数据开发了一种用于临床环境的工具,以确定孕24⁺⁰至31⁺⁶周出生的新生儿逐周的生存和发病情况。这些信息可用于做出与围产期护理相关的决策并为父母提供咨询。