Rao Y B, Yang J, Cao B, Chen D M, Gao P M, Zhong Q, Li M X, Gao J H, Chen Y J, Zhong X M, Ren Z X
Neonatology Department, Guangdong Maternal and Children's Hospital, Guangzhou 511400, China.
Zhonghua Er Ke Za Zhi. 2017 Aug 2;55(8):608-612. doi: 10.3760/cma.j.issn.0578-1310.2017.08.012.
To investigate the prognostic effect of neonatal morbidities on poor outcomes at 12 months corrected age in very low birth weight (VLBW) premature infants . From November 2013 to October 2014, a multi-center retrospective study was conducted in 8 tertiary Maternal and Children's hospitals in Guangdong, Hunan and Fujian. The premature infants survived to a postmenstrual age (PMA) of 36 weeks with birth weight less than 1 500 g and without congenital diseases were included, and divided into two groups according to poor outcomes. The birth weight, gestational age, morbidities and poor outcomes (death, cerebral palsy, cognitive delay, et al) were recorded. Data were analyzed with Chi-square test to investigate the relationship between morbidities and poor outcomes. And the predictive effect of the top three morbidities were analyzed by Logistic regression analysis. Total of 834 VLBW premature infants (473 boys and 361 girls) finished the follow-up, whose average gestational age and birth weight were (30.6±1.8) weeks and (1 189±159)g. The incidences of BPD, severe ROP, NEC, brain injury and sepsis were 207 (24.8%), 119 (14.3%), 58 (7.0%), 281 (33.7%) and 124 (14.9%), respectively. There were significant differences between the two groups in the incidences of BPD, severe ROP, NEC, brain injury and sepsis(χ(2)=42.10, 47.20, 4.81, 44.28, 18.63, all <0.01), which had significant correlation with poor outcomes at 12 months corrected age. The three top morbidities were severe ROP, BPD and brain injury(=3.82, 2.90, 2.80). Combined morbidities with BPD, severe ROP and brain injury correlated with higher risk of poor outcomes (one morbidity, =3.14, β=1.15; two morbidities, =7.31, β=1.99; three morbidities, =22.41, β=3.11; all <0.01). BPD, severe ROP, NEC, brain injury and sepsis were the risk factors of poor outcomes at 12 months corrected age in VLBW infants. And the more combined morbidities with severe ROP, BPD and brain injury, the higher risk of poor outcomes in this population. Trial registration Clinical Trails, NCT03104946.
探讨极低出生体重（VLBW）早产儿新生儿疾病对矫正年龄12个月时不良结局的预后影响。2013年11月至2014年10月，在广东、湖南和福建的8家三级妇幼医院进行了一项多中心回顾性研究。纳入出生体重小于1500g、孕龄36周且无先天性疾病的存活早产儿，并根据不良结局分为两组。记录出生体重、孕龄、疾病及不良结局（死亡、脑瘫、认知延迟等）。采用卡方检验分析疾病与不良结局之间的关系，并通过Logistic回归分析三大疾病的预测作用。共有834例VLBW早产儿（473例男婴和361例女婴）完成随访，其平均孕龄和出生体重分别为（30.6±1.8）周和（1189±159）g。支气管肺发育不良（BPD）、重度视网膜病变（ROP）、坏死性小肠结肠炎（NEC）、脑损伤和败血症的发生率分别为207例（24.8%）、119例（14.3%）、58例（7.0%）及281例（33.7%）和124例（14.9%）。两组在BPD、重度ROP、NEC、脑损伤和败血症的发生率上存在显著差异（χ²=42.10、47.20、4.81、44.28、18.63，均P<0.01），这些与矫正年龄12个月时的不良结局显著相关。三大疾病为重度ROP、BPD和脑损伤（OR=3.82、2.90、2.80）。合并BPD、重度ROP和脑损伤与不良结局风险较高相关（一种疾病，OR=3.14，β=1.15；两种疾病，OR=7.31，β=1.99；三种疾病，OR=22.41，β=3.11；均P<0.01）。BPD、重度ROP、NEC、脑损伤和败血症是VLBW婴儿矫正年龄12个月时不良结局的危险因素。且重度ROP、BPD和脑损伤合并的疾病越多，该人群不良结局风险越高。试验注册Clinical Trails，NCT03104946。
