Bezzine Ahlem, Chebbi Imen, Ben Hamida Emira, Marrakchi Zahra
Tunis Med. 2018 Dec;96(12):884-887.
Prematurity is a major public health problem and it's associated with a high mortality and morbidity. In Tunisia, few investigations studied this area.
To determine the rate and the risk factors of in-hospital mortality of very preterm infants.
We conducted a retrospective monocentric study. We included all premature Infants born at less than 326 weeks of gestation (< 33 Weeks) without major congenital anomalies admitted from January 2011 to December 2012 in the neonatal intensive care unit (NICU) of Charles Nicolle Hospital (Tunis-Tunisia). To determine in-hospital mortality related risk factors, we created and compared two groups: group of "Survivors" until discharge from our hospital and group of "Dead" before discharge. Multivariable logistic regression models were used to assess the association between risk factors and in-hospital mortality. P-value < 0.05 was considered statistically significant.
During the study period, 7606 livebirths (LB) were recorded; among them 113 were very premature infants. The prevalence of high prematurity was 1,4 % LB. Very premature infants were divided in 24 extremely preterm infant (13%) and 89 moderately preterm infants (87%). Mean weight at admission was 1338g (±349g) and the mean gestational age was 30 weeks (±1,7). The mean hospital stay was 26 days (±17days) with an average weight at discharge of 1942g (±249). Neonatal morbidity was mainly caused by respiratory distress (42%), early neonatal anemia (64%), intraventricular hemorrhagea (15%), associated-care health infection (37,6%). In hospital mortality rate was 32 %. Mortality risk factors identified through multivariate analysis were: extreme premature infant (p<0,05), extremely low birth weight (p<0,01) and circulatory disorders (p<0,05).
Very preterm infant represented 1,4 % of all live births. The mortality rate of very premature infant is still high and mainly associated to neonatal respiratory distress. Improving prevention and neonatal management still very required.
早产是一个主要的公共卫生问题，与高死亡率和高发病率相关。在突尼斯，很少有调查研究该领域。
确定极早产儿的院内死亡率及危险因素。
我们进行了一项回顾性单中心研究。纳入2011年1月至2012年12月在突尼斯市查尔斯·尼科勒医院新生儿重症监护病房（NICU）收治的所有孕周小于326周（<33周）且无重大先天性异常的早产婴儿。为确定与院内死亡相关的危险因素，我们创建并比较了两组：直至从我院出院的“存活者”组和出院前“死亡”组。采用多变量逻辑回归模型评估危险因素与院内死亡率之间的关联。P值<0.05被认为具有统计学意义。
在研究期间，记录了7606例活产（LB）；其中113例为极早产儿。高早产率为1.4%LB。极早产儿分为24例极早早产儿（13%）和89例中度早产儿（87%）。入院时平均体重为1338g（±349g），平均孕周为30周（±1.7）。平均住院时间为26天（±17天），出院时平均体重为1942g（±249）。新生儿发病率主要由呼吸窘迫（42%）、早期新生儿贫血（64%）、脑室内出血（15%）、相关护理健康感染（37.6%）引起。院内死亡率为32%。通过多变量分析确定的死亡危险因素为：极早早产儿（p<0.05）、极低出生体重（p<0.01）和循环系统疾病（p<0.05）。
极早产儿占所有活产的1.4%。极早产儿的死亡率仍然很高，主要与新生儿呼吸窘迫有关。仍非常需要改善预防和新生儿管理。
