Department of Neonatology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, #2699, Gaoke western Road, Pudong District, Shanghai, 201204, China.
World J Pediatr. 2020 Jun;16(3):299-304. doi: 10.1007/s12519-019-00322-7. Epub 2019 Nov 4.
Pulmonary hemorrhage (PH) is a life-threatening respiratory complication of extremely low-birth-weight infants (ELBWIs). However, the risk factors for PH are controversial. Therefore, the purpose of this study was to analyze the perinatal risk factors and short-term outcomes of PH in ELBWIs.
This was a retrospective cohort study of live born infants who had birth weights that were less than 1000 g, lived for at least 12 hours, and did not have major congenital anomalies. A logistic regression model was established to analyze the risk factors associated with PH.
There were 168 ELBWIs born during this period. A total of 160 infants were included, and 30 infants were diagnosed with PH. Risk factors including gestational age, small for gestational age, intubation in the delivery room, surfactant in the delivery room, repeated use of surfactant, higher FiO during the first day, invasive ventilation during the first day and early onset sepsis (EOS) were associated with the occurrence of PH by univariate analysis. In the logistic regression model, EOS was found to be an independent risk factor for PH. The mortality and intraventricular hemorrhage rate of the group of ELBWIs with PH were significantly higher than those of the group of ELBWIs without PH. The rates of periventricular leukomalacia, moderate-to-severe bronchopulmonary dysplasia and severe retinopathy of prematurity, and the duration of the hospital stay were not significantly different between the PH and no-PH groups.
Although PH did not extend hospital stay or increase the risk of bronchopulmonary dysplasia, it increased the mortality and intraventricular hemorrhage rate in ELBWIs. EOS was the independent risk factor for PH in ELBWIs.
肺出血（PH）是极低出生体重儿（ELBWIs）的一种危及生命的呼吸系统并发症。然而，PH 的危险因素仍存在争议。因此，本研究旨在分析 ELBWIs 中 PH 的围产期危险因素和短期结局。
这是一项对出生体重小于 1000g、至少存活 12 小时且无重大先天畸形的活产婴儿进行的回顾性队列研究。建立逻辑回归模型分析与 PH 相关的危险因素。
在此期间有 168 例 ELBWIs 出生。共有 160 例婴儿纳入研究，其中 30 例婴儿被诊断为 PH。单因素分析显示，胎龄、小于胎龄儿、产房内插管、产房内使用肺表面活性物质、重复使用肺表面活性物质、第 1 天 FiO2 较高、第 1 天有创通气和早发性败血症（EOS）与 PH 的发生有关。在逻辑回归模型中，EOS 被发现是 PH 的独立危险因素。PH 组的死亡率和脑室内出血发生率明显高于无 PH 组。两组的脑室周围白质软化、中重度支气管肺发育不良和重度早产儿视网膜病变的发生率以及住院时间均无显著差异。
虽然 PH 没有延长住院时间或增加支气管肺发育不良的风险，但增加了 ELBWIs 的死亡率和脑室内出血率。EOS 是 ELBWIs 中 PH 的独立危险因素。
