Tran Hoang T, Doyle Lex W, Lee Katherine J, Dang Na M, Graham Stephen M
Neonatal Unit, Department of Paediatrics, Da Nang Hospital for Women and Children, Da Nang, Vietnam; Centre for International Child Health, University of Melbourne Department of Paediatrics and Murdoch Childrens Research Institute, Royal Children's Hospital, Melbourne, Vic., Australia.
Acta Paediatr. 2015 May;104(5):e200-5. doi: 10.1111/apa.12960. Epub 2015 Mar 9.
This study explored neonatal morbidity and mortality in hospitalised patients in central Vietnam and risk factors associated with mortality.
We conducted a prospective cohort study of all newborn infants (<28 days) hospitalised in a neonatal unit over a 1-year period and followed until discharge. The main outcome measures were case fatality rate and the rate of different clinical diagnoses.
There were 2555 admissions during the study period. The leading primary causes of admissions were infections (41%), haematological problems such as jaundice (23%) and prematurity and its complications (18%). The overall case fatality rate was 8.6%, and it was 59% among very low-birthweight (<1500 g) neonates. Mortality was inversely associated with birthweight and gestational age. Of the 220 deaths, 57% occurred within the first 7 days of life. Although the causes of death were often multifactorial, the leading primary causes were infections (32%), prematurity and its complications (25%), birth defects (24%) and birth asphyxia (6%). Risk factors associated with death were being outborn, early gestational age, small for gestational age, confirmed sepsis and birth defects.
Mortality rates were high among hospitalised neonates in central Vietnam, and this paper suggests interventions that might improve outcomes.
本研究探讨了越南中部住院新生儿的发病率和死亡率以及与死亡相关的危险因素。
我们对一家新生儿病房1年内收治的所有新生儿(<28天)进行了一项前瞻性队列研究,并随访至出院。主要结局指标为病死率和不同临床诊断率。
研究期间共收治2555例。入院的主要原发性病因是感染(41%)、血液学问题如黄疸(23%)以及早产及其并发症(18%)。总体病死率为8.6%,极低出生体重(<1500g)新生儿的病死率为59%。死亡率与出生体重和胎龄呈负相关。在220例死亡病例中,57%发生在出生后7天内。虽然死亡原因往往是多因素的,但主要原发性病因是感染(32%)、早产及其并发症(25%)、出生缺陷(24%)和出生窒息(6%)。与死亡相关的危险因素是院外出生、孕周早、小于胎龄、确诊败血症和出生缺陷。
越南中部住院新生儿死亡率较高,本文提出了可能改善结局的干预措施。