Morgillo Davide, Morgillo-Mitchell Jane, Fontanta Matteo, Steurer Martina, Schmitt-Mechelke Thomas, Bauder Florian, Berger Thomas M
Neonatal and Paediatric Intensive Care Unit, Children's Hospital of Lucerne, Switzerland.
Division of Paediatric Critical Care, University of California, San Francisco, California, USA.
Swiss Med Wkly. 2014 Sep 25;144:w14014. doi: 10.4414/smw.2014.14014. eCollection 2014.
To determine the impact of a pro-active treatment approach on outcome of extremely low gestational age neonates (ELGANs; gestational age [GA] <28 weeks) born at the perinatal centre of Lucerne, Switzerland.
We assessed rates of survival, severe neonatal morbidity and neuro-developmental impairment (NDI) of all ELGANs born alive and treated at our centre between 2000 and 2009. The results were compared with published data from contemporary national and international cohorts.
Over the 10-year study period, a total of 216 ELGANs were born alive at the perinatal centre of Lucerne. The survival rate was 74% for all live-born infants, and 81% for those admitted to the neonatal intensive care unit. Among the 160 survivors, 25% sustained at least one major neonatal morbidity; severe brain injury (i.e., periventricular/intraventricular haemorrhage grade 3 or 4 and/or cystic periventricular leukomalacia) affected 10%; moderate or severe bronchopulmonary dysplasia 16%; retinopathy of prematurity ≥ stage 3 1%; and necrotising enterocolitis 2%. Neuro-developmental outcome data at 18 to 24 months was available for 92% of all survivors: 88% had no or mild NDI, whereas moderate and severe NDI were present in 10% and 2%, respectively.
When compared with published national or international data, our pro-active treatment approach to ELGANs was associated with higher or equal survival rates without increasing rates of severe neonatal morbidity or neuro-developmental impairment at the age of 18 to 24 months.
确定积极治疗方法对在瑞士卢塞恩围产期中心出生的极早产儿（ELGANs；胎龄[GA]<28周）结局的影响。
我们评估了2000年至2009年期间在我们中心出生并存活且接受治疗的所有ELGANs的存活率、严重新生儿发病率和神经发育障碍（NDI）。将结果与当代国内和国际队列的已发表数据进行比较。
在10年的研究期间，卢塞恩围产期中心共有216例ELGANs存活出生。所有活产婴儿的存活率为74%，入住新生儿重症监护病房的婴儿存活率为81%。在160名幸存者中，25%至少发生一种主要新生儿疾病；严重脑损伤（即3级或4级脑室周围/脑室内出血和/或脑室周围白质软化囊性变）占10%；中度或重度支气管肺发育不良占16%；早产儿视网膜病变≥3期占1%；坏死性小肠结肠炎占2%。92%的幸存者有18至24个月的神经发育结局数据：88%无或有轻度NDI，而中度和重度NDI分别占10%和2%。
与已发表的国内或国际数据相比，我们对ELGANs的积极治疗方法与更高或相等的存活率相关，且在18至24个月时未增加严重新生儿发病率或神经发育障碍的发生率。
