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印度北部一家三级护理单位 2013-2018 年出生队列中极低出生体重(ELBW)婴儿的结局。

Outcome of extremely low birth weight (ELBW) infants from a birth cohort (2013-2018) in a tertiary care unit in North India.

机构信息

Division of Neonatology, Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), New Delhi, India.

出版信息

J Perinatol. 2020 May;40(5):743-749. doi: 10.1038/s41372-020-0604-6. Epub 2020 Feb 14.

Abstract

OBJECTIVE

To evaluate mortality and short-term morbidities in extremely low birth weight (ELBW) infants (<1000 g) in a birth cohort in North India.

METHODS

In-hospital data of 231 ELBW infants (Jan 2013 to Sept 2018) were collected from a prospectively maintained electronic database by using standard definitions.

RESULTS

The mean (SD) gestation and birth weight were 27.9 (2.2) weeks and 783 (133) g, respectively. Major morbidities included respiratory distress syndrome (n = 132, 57%), moderate-to-severe bronchopulmonary dysplasia (n = 62, 26.8%), hemodynamically significant patent ductus arteriosus (n = 65, 28%), intracranial hemorrhage ≥ grade II (n = 38, 16%), and culture-positive sepsis (n = 44, 19%). Median (IQR) duration of hospital stay (survivors) was 50 (17-79) days. The overall survival was 62%. On logistic regression, severe birth asphyxia, gestation ≤26 weeks, and respiratory distress syndrome were major predictors of mortality.

CONCLUSION

In the current ELBW cohort, nearly two-thirds survived until discharge, who had considerable morbidities needing prolonged hospital stay. This study can be utilized for counseling and planning of care of ELBW infants in similar settings.

摘要

目的

评估印度北部一个出生队列中极低出生体重(ELBW)婴儿(<1000g)的死亡率和短期发病率。

方法

通过使用标准定义,从一个前瞻性维护的电子数据库中收集了 231 名 ELBW 婴儿(2013 年 1 月至 2018 年 9 月)的住院数据。

结果

平均(SD)胎龄和出生体重分别为 27.9(2.2)周和 783(133)g。主要并发症包括呼吸窘迫综合征(n=132,57%)、中重度支气管肺发育不良(n=62,26.8%)、有血流动力学意义的动脉导管未闭(n=65,28%)、颅内出血≥Ⅱ级(n=38,16%)和培养阳性败血症(n=44,19%)。(幸存者)中位数(IQR)住院时间为 50(17-79)天。总体生存率为 62%。在逻辑回归中,严重出生窒息、胎龄≤26 周和呼吸窘迫综合征是死亡的主要预测因素。

结论

在目前的 ELBW 队列中,近三分之二的婴儿存活至出院,但仍存在大量需要长期住院治疗的并发症。本研究可用于类似环境中 ELBW 婴儿的咨询和护理计划。

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