Bolisetty Srinivas, Legge Nele, Bajuk Barbara, Lui Kei
Division of Newborn Services, Royal Hospital for Women, Sydney, New South Wales, Australia.
University of New South Wales, Sydney, New South Wales, Australia.
J Paediatr Child Health. 2015 Jul;51(7):713-21. doi: 10.1111/jpc.12848. Epub 2015 Feb 3.
This study aimed to provide updated information on gestation-specific hospital outcomes of extreme to very preterm infants admitted to neonatal intensive care units.
A population-based retrospective cohort study of infants born between 23(+0) and 31(+6) weeks gestation and admitted to a network of neonatal intensive care units between 2007 and 2011 in a well-defined geographic area of New South Wales and the Australian Capital Territory. Main outcome measures were survival and major morbidities prior to hospital discharge.
Of 4454 infants included, hospital survival rates based on gestational age alone were 27%, 59%, 76%, 85%, 91% and over 95% at 23, 24, 25, 26, 27 and 28-31 weeks, respectively. Survival rates for each week up to 29 weeks gestation differed by at least 5% when perinatal risk factors including birthweight percentile, exposure to antenatal steroids, birth outside a tertiary hospital and gender were included in the survival estimation. All the major outcome figures were then simplified and displayed in a simple, easy-to-understand preterm outcome table for counselling purposes.
We report the latest hospital outcomes of extreme to very preterm infants in New South Wales and the Australian Capital Territory. Survival rates based on gestational age alone may not provide the true estimate as the survival for these infants can vary based on the presence or absence of other relevant perinatal factors.
本研究旨在提供入住新生儿重症监护病房的极早产儿至超早产儿特定孕周的医院结局最新信息。
一项基于人群的回顾性队列研究,研究对象为2007年至2011年间在新南威尔士州和澳大利亚首都直辖区明确地理区域内出生且孕周为23(+0)至31(+6)周并入住新生儿重症监护病房网络的婴儿。主要结局指标为出院前的生存率和主要疾病发生率。
纳入的4454例婴儿中,仅根据孕周计算的医院生存率在23、24、25、26、27和28 - 31周时分别为27%、59%、76%、85%、91%和超过95%。在生存估计中纳入出生体重百分位数、产前使用类固醇、在非三级医院出生和性别等围产期危险因素后,孕29周前各周的生存率差异至少为5%。然后简化所有主要结局数据,并以简单易懂的早产结局表形式呈现,用于咨询。
我们报告了新南威尔士州和澳大利亚首都直辖区极早产儿至超早产儿的最新医院结局。仅基于孕周的生存率可能无法提供真实估计,因为这些婴儿的生存可能因其他相关围产期因素的存在与否而有所不同。