Cokyaman Turgay, Kavuncuoglu Sultan
Department of Pediatrics, Istanbul Bakirkoy Maternity and Children's Research and Training Hospital, Istanbul, Turkey.
North Clin Istanb. 2019 Aug 9;7(2):124-130. doi: 10.14744/nci.2019.23427. eCollection 2020.
In this study, the relationship between the frequency of bronchopulmonary dysplasia, perinatal risk factors and other prematurity comorbidities were evaluated in very low birth weight infants.
A total of 872 very low birth weight infants' files were retrospectively reviewed. The effects of the clinical parameters, such as type of birth, small for gestational age, gender, antenatal steroids, early membrane rupture, chorioamnionitis, surfactant administration, respiratory distress syndrome, patent ductus arteriosus, apnea, early and late sepsis on the frequency of bronchopulmonary dysplasia, were evaluated by binary logistic regression analysis.
The overall mortality rate was 20.9%. After the first 28-day mortality reduction, the total bronchopulmonary dysplasia frequency was found to be 20.1%. The odds ratio and 95% confidence intervals of the factors affecting the development of bronchopulmonary dysplasia were found to be as follows respectively: respiratory distress syndrome (OR 6.2, 95% CI 3.6-10.6, p<0.01), patent ductus arteriosus (OR 4.9, 95% Cl 2.4-9.9, p<0.01), apnea (OR 4.1, 95% CI 2.5-6.9, p<0.01), late sepsis (OR 2.7, 95% CI 1.6-4.5, p<0.01), early membrane rupture (OR 2.6, 95% Cl 1.2-5.5, p=0.01), and male gender (OR 1.6, 95% CI 1.0-2.7, p=0.04) was found. However, there was no effect of chorioamnionitis, antenatal steroids, small for gestational age, early sepsis and type of birth on bronchopulmonary dysplasia.
Differently from the usual factors which are low birth weight and a gestational week, there was a significant but non-linear risk relationship between respiratory distress syndrome, patent ductus arteriosus, late sepsis, apnea, early membrane rupture, male gender and bronchopulmonary dysplasia.
本研究评估极低出生体重儿支气管肺发育不良的发生率与围产期危险因素及其他早产合并症之间的关系。
回顾性分析872例极低出生体重儿的病历。通过二元逻辑回归分析评估出生类型、小于胎龄、性别、产前使用类固醇、胎膜早破、绒毛膜羊膜炎、使用表面活性剂、呼吸窘迫综合征、动脉导管未闭、呼吸暂停、早发性和晚发性败血症等临床参数对支气管肺发育不良发生率的影响。
总体死亡率为20.9%。在最初28天死亡率降低后,支气管肺发育不良的总发生率为20.1%。影响支气管肺发育不良发生的因素的比值比及95%置信区间分别如下:呼吸窘迫综合征(比值比6.2,95%置信区间3.6 - 10.6,p<0.01)、动脉导管未闭(比值比4.9,95%置信区间2.4 - 9.9,p<0.01)、呼吸暂停(比值比4.1,95%置信区间2.5 - 6.9,p<0.01)、晚发性败血症(比值比2.7,95%置信区间1.6 - 4.5,p<0.01)、胎膜早破(比值比2.6,95%置信区间1.2 - 5.5,p = 0.01)以及男性(比值比1.6,95%置信区间1.0 - 2.7,p = 0.04)。然而,绒毛膜羊膜炎、产前使用类固醇、小于胎龄儿、早发性败血症和出生类型对支气管肺发育不良无影响。
与通常的低出生体重和孕周等因素不同,呼吸窘迫综合征、动脉导管未闭、晚发性败血症、呼吸暂停、胎膜早破、男性与支气管肺发育不良之间存在显著但非线性的风险关系。