围产期因素对妊娠23周出生婴儿短期和长期结局的影响。

Influence of perinatal factors in short- and long-term outcomes of infants born at 23 weeks of gestation.

作者信息

Miltaha Hamzah R, Fahey Lisa M, Sajous Christine H, Morrison John C, Muraskas Jonathan K

机构信息

Division of Neonatal Medicine, Department of Pediatrics, Loyola University Medical Center, Maywood, Illinois.

Department of Pediatrics, New York Presbyterian-Weill Cornell Medical Center, New York, New York.

出版信息

Am J Perinatol. 2015 Jun;32(7):627-32. doi: 10.1055/s-0034-1390350. Epub 2014 Dec 8.

DOI:10.1055/s-0034-1390350

PMID:25486287

Abstract

OBJECTIVE

Investigate the influence of perinatal factors on short- and long-term outcomes for infants born at 23 weeks of gestation.

STUDY DESIGN

This is a retrospective study over a 25-year period (1987-2011) of 87 successfully resuscitated infants at 23 weeks of gestation. We investigated the effects of poor prenatal care, race, gender, chorioamnionitis, antenatal corticosteroids, delivery route/location, low 5-minute Apgar score, birth weight, and multiple births on short- and long-term outcomes.

RESULTS

The mortality rate was 43% (37/87). A total of 88% (44/50) of the survivors were followed at 2 years corrected age with 66% (29/44) diagnosed with a moderate-to-severe neurological impairment. Outborn and multiple birth infants had significantly higher mortality (p-value 0.042 and 0.006, respectively). Lack of exposure to antenatal steroids and lower birth weight significantly increased the disability score (p-value 0.042 and 0.003, respectively).

CONCLUSION

Multiple perinatal factors significantly influence outcomes at the threshold of viability.

摘要

目的

研究围产期因素对孕23周出生婴儿短期和长期结局的影响。

研究设计

这是一项为期25年（1987 - 2011年）的回顾性研究，涉及87例孕23周成功复苏的婴儿。我们调查了产前护理差、种族、性别、绒毛膜羊膜炎、产前使用糖皮质激素、分娩途径/地点、5分钟阿氏评分低、出生体重及多胎妊娠对短期和长期结局的影响。

结果

死亡率为43%（37/87）。共有88%（44/50）的存活者在矫正年龄2岁时接受随访，其中66%（29/44）被诊断为中重度神经功能障碍。院外出生婴儿和多胎婴儿的死亡率显著更高（p值分别为0.042和0.006）。未使用产前糖皮质激素和出生体重较低显著增加了残疾评分（p值分别为0.042和0.003）。