Neonatal Unit, Department of Pediatrics, University Hospital of Kinshasa, Kinshasa, DR Congo.
Pregnancy, Fetus and Newborn, Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
Acta Paediatr. 2018 Aug;107(8):1345-1349. doi: 10.1111/apa.14263. Epub 2018 Mar 1.
Perinatal asphyxia is one of the most frequent causes of neonatal morbidity and mortality worldwide, and 96% of the burden of neonatal encephalopathy occurs in low-income countries. This study investigated the feasibility of providing neuroprotective treatment for neonatal encephalopathy in low-income countries.
Neonates with a gestational age of at least 36 weeks, with signs of perinatal asphyxia, were included in this 2015 observational study in three hospitals in Kinshasa, capital of the Democratic Republic of Congo. Their characteristics were described, including the time to admission and Thompson score on admission.
We found that 42 of 134 patients (31.3%) reached the hospital within six hours of birth with a Thompson score of at least seven on admission. Another 15 patients (11.2%) had a five-minute Apgar score of up to five, without a Thompson score, and were eligible for treatment. Of the 57 (42.5%) eligible patients, 31 were discharged (54.4%), 25 died (43.9%) and one (1.8%) remained in hospital at the end of the study.
Interventional studies are feasible and necessary, especially in countries where the burden of neonatal encephalopathy is largest. A Thompson score of 7-15 might be a useful entry criterion for neuroprotective treatment in low-income countries.
围产期窒息是全球新生儿发病率和死亡率最常见的原因之一，96%的新生儿脑病负担发生在低收入国家。本研究旨在探讨在低收入国家为新生儿脑病提供神经保护治疗的可行性。
本 2015 年观察性研究纳入了刚果民主共和国首都金沙萨的三家医院的至少 36 周胎龄、有围产期窒息迹象的新生儿。描述了他们的特征，包括入院时间和入院时的 Thompson 评分。
我们发现，134 例患者中有 42 例（31.3%）在出生后 6 小时内到达医院，入院时 Thompson 评分为 7 分及以上。另有 15 例（11.2%）出生后 5 分钟 Apgar 评分为 5 分及以下，没有 Thompson 评分，但有资格接受治疗。在 57 例（42.5%）符合条件的患者中，31 例出院（54.4%），25 例死亡（43.9%），1 例（1.8%）在研究结束时仍在住院。
干预性研究是可行且必要的，特别是在新生儿脑病负担最大的国家。Thompson 评分为 7-15 可能是低收入国家神经保护治疗的有用纳入标准。
