主要畸形和出生体重影响13三体或18三体综合征患儿的新生儿重症监护病房干预措施及死亡率。
Major anomalies and birth-weight influence NICU interventions and mortality in infants with trisomy 13 or 18.
作者信息
Acharya K, Leuthner S, Clark R, Nghiem-Rao T H, Spitzer A, Lagatta J
机构信息
Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA.
Pediatrix Medical Group, Sunrise, FL, USA.
出版信息
J Perinatol. 2017 Apr;37(4):420-426. doi: 10.1038/jp.2016.245. Epub 2017 Jan 12.
OBJECTIVE
To describe neonatal intensive care unit (NICU) medical interventions and NICU mortality by birth weight and major anomaly types for infants with trisomy 13 (T13) or 18 (T18).
STUDY DESIGN
Retrospective cohort analysis of infants with T13 or T18 from 2005 to 2012 in the Pediatrix Medical Group. We classified infants into three groups by associated anomaly type: neonatal surgical, non-neonatal surgical and minor. Outcomes were NICU medical interventions and mortality.
RESULTS
841 infants were included from 186 NICUs. NICU mortality varied widely by anomaly type and birth weight, from 70% of infants <1500 g with neonatal surgical anomalies to 31% of infants ⩾2500 g with minor anomalies. Infants ⩾1500 g without a neonatal surgical anomaly comprised 66% of infants admitted to the NICU; they had the lowest rates of NICU medical interventions and NICU mortality.
CONCLUSIONS
Risk stratification by anomaly type and birth weight may help provide more accurate family counseling for infants with T13 and T18.
目的
描述13三体（T13）或18三体（T18）婴儿在新生儿重症监护病房（NICU）的医疗干预情况以及按出生体重和主要异常类型划分的NICU死亡率。
研究设计
对2005年至2012年在Pediatrix医疗集团的T13或T18婴儿进行回顾性队列分析。我们按相关异常类型将婴儿分为三组：新生儿外科、非新生儿外科和轻微异常。结局指标为NICU医疗干预和死亡率。
结果
来自186个NICU的841名婴儿被纳入研究。NICU死亡率因异常类型和出生体重的不同而有很大差异，从出生体重<1500克且有新生儿外科异常的婴儿中的70%到出生体重≥2500克且有轻微异常的婴儿中的31%。出生体重≥1500克且无新生儿外科异常的婴儿占入住NICU婴儿的66%；他们的NICU医疗干预率和NICU死亡率最低。
结论
按异常类型和出生体重进行风险分层可能有助于为T13和T18婴儿的家庭提供更准确的咨询。
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