Iacobelli Silvia, Combier Evelyne, Roussot Adrien, Cottenet Jonathan, Gouyon Jean-Bernard, Quantin Catherine
Centre d'Etudes Périnatales de l'Océan Indien, CHU Sud Réunion, La Réunion, France.
Réanimation Néonatale et Pédiatrique, Néonatologie, CHU La Réunion, France.
BMC Pediatr. 2017 Jan 18;17(1):28. doi: 10.1186/s12887-017-0787-y.
Describe the 1-year hospitalization and in-hospital mortality rates, in infants born after 31 weeks of gestational age (GA).
This nation-wide population-based study used the French medico-administrative database to assess the following outcomes in singleton live-born infants (32-43 weeks) without congenital anomalies (year 2011): neonatal hospitalization (day of life 1 - 28), post-neonatal hospitalization (day of life 29 - 365), and 1-year in-hospital mortality rates. Marginal models and negative binomial regressions were used.
The study included 696,698 live-born babies. The neonatal hospitalization rate was 9.8%. Up to 40 weeks, the lower the GA, the higher the hospitalization rate and the greater the likelihood of requiring the highest level of neonatal care (both p < 0.001). The relative risk adjusted for sex and pregnancy-related diseases (aRR) reached 21.1 (95% confidence interval [CI]: 19.2-23.3) at 32 weeks. The post-neonatal hospitalization rate was 12.1%. The raw rates for post-neonatal hospitalization fell significantly from 32 - 40 and increased at 43 weeks and this persisted after adjustment (aRR = 3.6 [95% CI: 3.3-3.9] at 32 and 1.5 [95% CI: 1.1-1.9] at 43 compared to 40 weeks). The main causes of post-neonatal hospitalization were bronchiolitis (17.2%), gastroenteritis (10.4%) ENT diseases (5.4%) and accidents (6.2%). The in-hospital mortality rate was 0.85‰, with a significant decrease (p < 0.001) according to GA at birth (aRR = 3.8 [95% CI: 2.4-5.8] at 32 and 6.6 [95% CI: 2.1-20.9] at 43, compared to 40 weeks.
There's a continuous change in outcome in hospitalized infants born above 31 weeks. Birth at 40 weeks gestation is associated with the lowest 1-year morbidity and mortality.
描述孕龄（GA）31周后出生的婴儿的1年住院率和院内死亡率。
这项基于全国人口的研究使用法国医疗行政数据库评估2011年出生的无先天性异常的单胎活产婴儿（32 - 43周）的以下结局：新生儿住院（出生后第1 - 28天）、新生儿后期住院（出生后第29 - 365天）和1年院内死亡率。使用了边际模型和负二项回归。
该研究纳入了696,698例活产婴儿。新生儿住院率为9.8%。直至40周，GA越低，住院率越高，需要最高级新生儿护理的可能性越大（均p < 0.001）。32周时，经性别和妊娠相关疾病调整后的相对风险（aRR）达到21.1（95%置信区间[CI]：19.2 - 23.3）。新生儿后期住院率为12.1%。新生儿后期住院的原始率在32 - 40周时显著下降，在43周时上升，调整后这种情况仍然存在（与40周相比，32周时aRR = 3.6 [95% CI：3.3 - 3.9]，43周时为1.5 [95% CI：1.1 - 1.9]）。新生儿后期住院的主要原因是细支气管炎（17.2%）、肠胃炎（10.4%）、耳鼻喉疾病（5.4%）和意外事故（6.2%）。院内死亡率为0.85‰，根据出生时的GA有显著下降（p < 0.001）（与40周相比，32周时aRR = 3.8 [95% CI：2.4 - 5.8]，43周时为6.6 [95% CI：2.1 - 20.9]）。
孕龄31周以上出生的住院婴儿的结局存在持续变化。孕40周出生与1年最低发病率和死亡率相关。
