Khasawneh Wasim, Sindiani Amer, Rawabdeh Saif Aldeen, Aleshawi Abdelwahhab, Kanaan Dana
Department of Pediatrics and Neonatology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan.
J Multidiscip Healthc. 2020 Sep 23;13:997-1006. doi: 10.2147/JMDH.S275267. eCollection 2020.
To review the indications and clinical profile of neonatal admissions at King Abdullah University Hospital in Jordan.
We conducted a cross-sectional review of all neonates admitted to the neonatal intensive care unit between September 2016 and September 2018. Collected data include demographic characteristics, indications for admission, morbidities and mortality, and discharge outcomes. Findings were reported among term and preterm infants.
A total of 1444 infants were admitted during the study period of whom 1332 (92.2%) were inborn and 612 (42.4%) were term neonates. Of the 832 preterm infants, 545 were late preterm (34-36 6/7 gestation) and 125 had very low birth weight (˂ 1500 grams); 925 (64%) were born by cesarean section. Respiratory failure of the newborn (41.2%) and prematurity (33.3%) were the main indications for admission among the whole cohort. Maternal prolonged premature rupture of membranes (PROM) was observed in nearly half the admissions of term infants. Hypoxic ischemic encephalopathy (3.2% vs 0.7%, p 0.01) and congenital anomalies (5% vs 1.2%, p 0.03) were more common in term infants. The rate of bronchopulmonary dysplasia was 39% among <28-week and 28% among <32-week premature infants. Sepsis was encountered in 59 infants. The overall mortality rate was 3.8%. Prematurity was the main predisposing factor for mortality (Adjusted OR: 9.9, 95% CI: 3.5, 27.6).
The majority of neonatal admissions at our institution are term and late preterm infants delivered by cesarean section. Prematurity, respiratory failure of the newborn, and suspected sepsis due to maternal PROM are the leading causes of admission. The mortality rate is within WHO target to achieve Sustainable Development Goal 3. Population-based studies are needed to make better conclusions that represent the whole Jordanian population. A revisit for the indications of cesarean deliveries may help to improve the neonatal outcomes.
回顾约旦阿卜杜拉国王大学医院新生儿入院的指征及临床概况。
我们对2016年9月至2018年9月期间入住新生儿重症监护病房的所有新生儿进行了横断面回顾性研究。收集的数据包括人口统计学特征、入院指征、发病率和死亡率以及出院结局。研究结果按足月儿和早产儿分别报告。
在研究期间，共有1444名婴儿入院，其中1332名（92.2%）为足月儿，612名（42.4%）为足月儿。在832名早产儿中，545名是晚期早产儿（孕周34 - 36⁶/₇周），125名出生体重极低（<1500克）；925名（64%）通过剖宫产出生。新生儿呼吸衰竭（41.2%）和早产（33.3%）是整个队列中入院的主要指征。在近一半的足月儿入院病例中观察到产妇胎膜早破时间延长。足月儿中缺氧缺血性脑病（3.2%对0.7%，p<0.01）和先天性异常（5%对1.2%，p<0.03）更为常见。<28周早产儿支气管肺发育不良的发生率为39%，<32周早产儿为28%。59名婴儿发生败血症。总体死亡率为3.8%。早产是死亡的主要危险因素（校正比值比：9.9，95%置信区间：3.5，27.6）。
我们机构大多数新生儿入院病例是通过剖宫产出生的足月儿和晚期早产儿。早产、新生儿呼吸衰竭以及因产妇胎膜早破导致的疑似败血症是入院的主要原因。死亡率在世卫组织实现可持续发展目标3的目标范围内。需要开展基于人群的研究，以便得出更能代表整个约旦人口的更好结论。重新审视剖宫产的指征可能有助于改善新生儿结局。
