García-Muñoz Rodrigo Fermín, Urquía Martí Lourdes, Galán Henríquez Gloria, Rivero Rodríguez Sonia, Tejera Carreño Patricia, Molo Amorós Silvia, Cabrera Vega Pedro, Rodríguez Ramón Fernando
a Hospital Materno-Infantil de Las Palmas de Gran Canaria , Las Palmas de Gran Canaria , Spain.
J Matern Fetal Neonatal Med. 2017 Nov;30(22):2679-2685. doi: 10.1080/14767058.2016.1261281. Epub 2016 Dec 7.
To determine the perinatal risk factors for pneumothorax in Very-Low-Birth-Weight (VLBW) infants and the associated morbidity and mortality in this population.
Retrospective analysis of data collected prospectively from a cohort of VLBW neonates assisted in our Unit (2006-2013). We included all consecutive in-born patients with ≤ 1500 g, without severe congenital anomalies. Perinatal history, demographics, interventions and clinical outcomes were collected. Associations were evaluated by logistic regression analysis.
During the study period, 803 VLBW infants were assisted in our Unit, of whom 763 were inborn. Ten patients (1.2%) died in delivery room, and 18 (2.2%) with major congenital anomalies were excluded. Finally, 735 (91.5%) neonates were included in the study. Seventeen (2.3%) developed pneumothorax during the first week of life [median (IQR): 2 (1-2) days]. After correcting for GA and other confounders, prolonged rupture of membranes [aOR =1.002 (95% CI 1.000-1.003); p = 0.040] and surfactant administration [aOR = 6.281 (95% CI 1.688-23.373); p = 0.006] were the independent risk factors associated with pneumothorax. Patients with pneumothorax had lower probabilities of survival without major brain damage (MBD): aOR = 0.283 (95% CI = 0.095-0.879); p = 0.029.
Pneumothorax in VLBW seems to be related to perinatal inflammation and surfactant administration, and it is significantly associated with a reduction in the probabilities of survival without MBD.
确定极低出生体重（VLBW）婴儿气胸的围产期危险因素以及该人群的相关发病率和死亡率。
对前瞻性收集的我院（2006 - 2013年）VLBW新生儿队列数据进行回顾性分析。纳入所有出生体重≤1500g、无严重先天性异常的连续出生患者。收集围产期病史、人口统计学资料、干预措施和临床结局。通过逻辑回归分析评估相关性。
研究期间，我院共收治803例VLBW婴儿，其中763例为出生时即入院。10例患者（1.2%）在产房死亡，18例（2.2%）有严重先天性异常被排除。最终，735例（91.5%）新生儿纳入研究。17例（2.3%）在出生后第一周发生气胸[中位数（四分位间距）：2（1 - 2）天]。校正胎龄和其他混杂因素后，胎膜早破[aOR = 1.002（95%CI 1.000 - 1.003）；p = 0.040]和使用表面活性剂[aOR = 6.281（95%CI 1.688 - 23.373）；p = 0.006]是与气胸相关的独立危险因素。发生气胸的患者无重大脑损伤（MBD）存活的概率较低：aOR = 0.283（95%CI = 0.095 - 0.879）；p = 0.029。
VLBW婴儿气胸似乎与围产期炎症和表面活性剂的使用有关，并且与无MBD存活概率的降低显著相关。
