García-Muñoz Rodrigo Fermín, García Hernández José Ángel, García-Alix Alfredo
a Neonatal Unit, Complejo Hospitalario Universitario Insular Materno-Infantil de Las Palmas de Gran Canaria , Las Palmas de Gran Canaria , Spain.
b Obstetric and Gynecology Department, Complejo Hospitalario Universitario Insular Materno-Infantil de Las Palmas de Gran Canaria , Las Palmas, de Gran Canaria , Spain , and.
J Matern Fetal Neonatal Med. 2017 Sep;30(18):2198-2203. doi: 10.1080/14767058.2016.1243095. Epub 2016 Oct 25.
To determine the sociodemographic and clinical characteristics of mothers of infants at the limit of viability and to know the perinatal factors associated to infants' survival.
Single-center cohort study of mothers and newborns assisted in our tertiary care center (2004-2010). Demographic and perinatal variables were compared between mothers who gave birth ≤26 weeks GA and the general population. The association between perinatal factors and neonatal survival was studied by Cox regression analysis.
Mothers of newborns ≤26 weeks (n = 136) had less education and pregnancy control. They had more frequently assisted reproductive technologies (ART) (5.2% versus 2.3%; p< 0.05), multiple gestations (16.6% versus 2.1%; p < 0.05), pregnancy complications and C-section (39.7% versus 13.4%; p < 0.001). After correcting for confounders, the perinatal factors independently associated with a variation in the risk of mortality were the administration of antenatal steroid [aHR (95%CI): 0.465 (0.254-0.853), p = 0.013], singleton pregnancy [aHR (95%CI): 0.482 (0.279-0.834), p = 0.009], infant's temperature on admission [aHR (95%CI): 0.642 (0.426-0.968), p = 0.035] and CRIB score [aHR (95%CI): 1.151 (1.058-1.251), p = 0.001].
Mothers of preterm infants at the limit of viability had more ART, multiple pregnancies, obstetrical complications and C-section. Infants' survival was independently associated to antenatal steroids, singleton pregnancy, temperature on admission and CRIB score.
确定处于生存极限的婴儿母亲的社会人口学和临床特征，并了解与婴儿存活相关的围产期因素。
在我们的三级护理中心（2004 - 2010年）对母亲和新生儿进行单中心队列研究。比较孕周≤26周分娩的母亲与一般人群的人口统计学和围产期变量。通过Cox回归分析研究围产期因素与新生儿存活之间的关联。
孕周≤26周新生儿的母亲（n = 136）受教育程度较低且孕期保健较少。她们更频繁地接受辅助生殖技术（ART）（5.2% 对2.3%；p < 0.05）、多胎妊娠（16.6% 对2.1%；p < 0.05）、妊娠并发症和剖宫产（39.7% 对13.4%；p < 0.001）。校正混杂因素后，与死亡风险变化独立相关的围产期因素是产前使用类固醇[aHR（95%CI）：0.465（0.254 - 0.853），p = 0.013]、单胎妊娠[aHR（95%CI）：0.482（0.279 - 0.834），p = 0.009]、婴儿入院时体温[aHR（95%CI）：0.642（0.426 - 0.968），p = 0.035]和CRIB评分[aHR（95%CI）：1.151（1.058 - 1.251），p = 0.001]。
处于生存极限的早产儿母亲接受更多的辅助生殖技术、多胎妊娠、产科并发症和剖宫产。婴儿存活与产前类固醇、单胎妊娠、入院时体温和CRIB评分独立相关。
