体重不足 750 克的早产儿的死亡率和发病率：一项为期 2 年的回顾性队列研究。

Mortality and morbidity of preterm neonates weighing less than 750g: A 2-year retrospective cohort study.

机构信息

Service de Médecine et Réanimation néonatales, maternité Port-Royal, Hôpital Cochin-Broca-Hôtel-Dieu, Assistance Publique-Hôpitaux de Paris, Université Paris V, 53, boulevard de l'Observatoire, 75014 Paris, France.

Département d'Anesthésie-Réanimation, Hôpital Bichat-Claude-Bernard, Assistance Publique- Hôpitaux de Paris, 75018 Paris, France.

出版信息

Arch Pediatr. 2020 May;27(4):227-232. doi: 10.1016/j.arcped.2020.02.003. Epub 2020 Apr 8.

DOI:10.1016/j.arcped.2020.02.003

PMID:32278588

Abstract

BACKGROUND

The rate of premature births in France is 6% and is increasing, as is the rate of extremely premature births. Morbidity and mortality rates in this population remain high despite significant medical progress. We aimed to evaluate the morbidity and mortality rate in preterm neonates weighing<750g and to evaluate their outcome at 2 years' corrected age (CA).

METHODS

This was a retrospective monocentric study including babies born between May 2011 and April 2013 who were preterm and weighed<750g. We evaluated mortality and morbidity in the neonatal period. At 2 years' CA, we focused on developmental quotient (DQ) with the Brunet-Lézine test, on neurosensory assessment (sleeping/behavior), and growth evaluation.

RESULTS

Among the 107 infants included, 29 (27%) died in the neonatal period. Mean gestational age was 25.6 weeks' gestation. Female sex and higher birth weight were independent predictors of survival. A total of 61 (78.2%) infants showed extra-uterine growth retardation at 36 weeks' postmenstrual age. At 2 years' CA, 57 children were followed up; 38 were evaluated using the Brunet-Lézine test, 20 (52.6%) had a DQc<85, and none had a severe developmental delay (DQc<50). Six (10%) children had cerebral palsy and 22 of 56 (39.2%) showed language delay. Growth retardation persisted in 15 of 52 (28.8%) children.

CONCLUSION

Our results confirm the acute fragility of extremely low-birth-weight babies with a high rate of morbidity and mortality. At 2 years' CA, this population still shows a considerable rate of mild difficulties, whose long-term evolution needs to be followed.

摘要

背景

法国的早产儿率为 6%，且呈上升趋势，极低出生体重儿的比率也是如此。尽管医学取得了重大进展，该人群的发病率和死亡率仍然很高。我们旨在评估体重<750g 的早产儿的发病率和死亡率，并评估他们在 2 年校正年龄（CA）时的结局。

方法

这是一项回顾性单中心研究，纳入了 2011 年 5 月至 2013 年 4 月出生的早产儿，体重<750g。我们评估了新生儿期的死亡率和发病率。在 2 年 CA 时，我们专注于发育商（DQ）的 Brunet-Lézine 测试、神经感觉评估（睡眠/行为）和生长评估。

结果

在纳入的 107 名婴儿中，29 名（27%）在新生儿期死亡。平均胎龄为 25.6 周。女性和较高的出生体重是存活的独立预测因素。共有 61 名（78.2%）婴儿在 36 周的孕龄时表现出宫外生长迟缓。在 2 年 CA 时，有 57 名儿童接受了随访；38 名使用 Brunet-Lézine 测试进行了评估，20 名（52.6%）的 DQc<85，无一例有严重发育迟缓（DQc<50）。6 名（10%）儿童患有脑瘫，22 名（56%）儿童语言发育迟缓。在 52 名儿童中，15 名（28.8%）存在生长迟缓持续存在。