22-24 孕周出生婴儿的药物治疗和院内转归。
Medications and in-hospital outcomes in infants born at 22-24 weeks of gestation.
机构信息
Department of Pediatrics, University of Washington, Seattle, WA, USA.
Department of Pediatrics, Duke University Medical Center, Durham, NC, USA.
出版信息
J Perinatol. 2020 May;40(5):781-789. doi: 10.1038/s41372-020-0614-4. Epub 2020 Feb 17.
Abstract
OBJECTIVE
To evaluate the most commonly used medications and in-hospital morbidities and mortality in infants born 22-24 weeks of gestation.
STUDY DESIGN
Multicenter retrospective cohort study of infants born 22-24 weeks of gestation (2006-2016), without major congenital anomalies and with available medication data obtained from neonatal intensive care units managed by the Pediatrix Medical Group.
RESULTS
This study included 7578 infants from 195 sites. Median (25th, 75th percentile): birthweight was 610 g (540, 680); the number of distinct medications used was 13 (8, 18); and different antimicrobial exposure was 4 (2, 5). The most common morbidities were BPD (41%) and grade III or IV IVH (20%), and overall survival varied from 46% (2006) to 57% (2016).
CONCLUSIONS
A large number of medications were used in periviable infants. There was a high prevalence of in-hospital morbidities, and survival of this population increased over the study period.
摘要
目的
评估孕 22-24 周出生的婴儿最常使用的药物和院内并发症及死亡率。
研究设计
这是一项多中心回顾性队列研究，纳入了 2006 年至 2016 年期间出生的孕 22-24 周（22-24 周）、无重大先天性畸形且可从 Pediatrix 医疗集团管理的新生儿重症监护病房获得药物使用数据的婴儿。
结果
本研究共纳入了来自 195 个地点的 7578 名婴儿。中位数（25 分位、75 分位）：出生体重为 610 克（540、680）；使用的不同药物数量为 13 种（8、18）；不同抗菌药物暴露为 4 种（2、5）。最常见的并发症是 BPD（41%）和 III 级或 IV 级 IVH（20%），整体存活率从 2006 年的 46%到 2016 年的 57%不等。
结论
极早产儿使用了大量药物。院内并发症发生率较高，且该人群的存活率在研究期间有所增加。
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3
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