巴西新生儿研究网络中心出生的极低出生体重儿的死亡或伴有严重发病情况的存活。
Death or survival with major morbidity in VLBW infants born at Brazilian neonatal research network centers.
作者信息
Guinsburg Ruth, de Almeida Maria Fernanda Branco, de Castro Junia Sampel, Silveira Rita C, Caldas Jamil Pedro de Siqueira, Fiori Humberto Holmer, do Vale Marynéa Silva, Abdallah Vânia Olivetti Steffen, Cardoso Laura Emilia Monteiro Bigélli, Alves Filho Navantino, Moreira Maria Elisabeth, Acquesta Ana Lucia, Ferrari Lígia S Lopes, Bentlin Maria Regina, Venzon Paulyne Stadler, Gonçalves Ferri Walusa Assad, Meneses Jucille do Amaral, Diniz Edna Maria De Albuquerque, Zanardi Dulce Maria Toledo, Dos Santos Cristina Nunes, Bandeira Duarte José Luiz, Rego Maria Albertina Santiago
机构信息
a Escola Paulista de Medicina, Universidade Federal de São Paulo , São Paulo , SP , Brazil .
b Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul , Porto Alegre , RS , Brazil .
出版信息
J Matern Fetal Neonatal Med. 2016 Mar;29(6):1005-9. doi: 10.3109/14767058.2015.1031740. Epub 2015 Apr 2.
OBJECTIVE
To analyze unfavorable outcomes at hospital discharge of preterm infants born at Brazilian public university centers.
METHODS
Prospective cohort of 2646 inborn infants with gestational age 23-33 weeks and birth weight 400-1499 g, without malformations, born at 20 centers in 2012-2013. Unfavorable outcome was defined as in-hospital death or survival at hospital discharge with ≥1 major morbidities: bronchopulmonary dysplasia (BPD) at 36 corrected weeks, intraventricular hemorrhage (IVH) grades 3-4, periventricular leukomalacia (PVL) or surgically treated retinopathy of prematurity (ROP).
RESULTS
Among 2646 infants, 1390 (53%) either died or survived with major morbidities: 793 (30%) died; 497 (19%) had BPD; 358 (13%) had IVH 3-4 or PVL; and 84 (3%) had ROP. Logistic regression adjusted by center showed association of unfavorable outcome with: antenatal steroids (OR 0.70; 95%CI 0.55-0.88), C-section (0.72; 0.58-0.90), gestational age <30 (4.00; 3.16-5.07), being male (1.44; 1.19-1.75), small for gestational age (2.19; 1.72-2.78), 5th-min Apgar <7 (3.89; 2.88-5.26), temperature at NICU admission <36.0 °C (1.42; 1.15-1.76), respiratory distress syndrome (3.87; 2.99-5.01), proven late sepsis (1.33; 1.05-1.69), necrotizing enterocolitis (3.10; 2.09-4.60) and patent ductus arteriosus (1.69; 1.37-2.09).
CONCLUSIONS
More than half of the VLBW infants born at public university level 3 Brazilian hospitals either die or survive with major morbidities.
目的
分析巴西公立大学中心出生的早产儿出院时的不良结局。
方法
对2012 - 2013年在20个中心出生的2646例胎龄23 - 33周、出生体重400 - 1499克、无畸形的足月儿进行前瞻性队列研究。不良结局定义为住院死亡或出院时存活且伴有≥1种主要疾病：矫正36周时的支气管肺发育不良（BPD）、3 - 4级脑室内出血（IVH）、脑室周围白质软化（PVL）或接受手术治疗的早产儿视网膜病变（ROP）。
结果
在2646例婴儿中，1390例（53%）死亡或存活并伴有主要疾病：793例（30%）死亡；497例（19%）患有BPD；358例（13%）患有3 - 4级IVH或PVL；84例（3%）患有ROP。经中心调整的逻辑回归显示不良结局与以下因素相关：产前使用类固醇（比值比[OR]0.70；95%置信区间[CI]0.55 - 0.88）、剖宫产（0.72；0.58 - 0.90）、胎龄<30周（4.00；3.16 - 5.07）、男性（1.44；1.19 - 1.75）、小于胎龄儿（2.19；1.72 - 2.78）、出生后5分钟阿氏评分<7分（3.89；2.88 - 5.26）、新生儿重症监护病房（NICU）入院时体温<36.0°C（1.42；1.15 - 1.76）、呼吸窘迫综合征（3.87；2.99 - 5.01）、确诊的晚发性败血症（1.33；1.05 - 1.69）、坏死性小肠结肠炎（3.10；2.09 - 4.60）和动脉导管未闭（1.69；1.37 - 2.09）。
结论
在巴西公立大学三级医院出生的极低出生体重婴儿中，超过一半要么死亡，要么存活并伴有主要疾病。
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