25 年来极低出生体重儿存活率：单中心经验。

Survival rate of very low birth weight infants over a quarter century (1994-2019): A single-institution experience.

机构信息

College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.

King Abdullah International Medical Research Center, Ministry of National Guard Health Affairs, Western Region, Jeddah, Saudi Arabia.

出版信息

J Neonatal Perinatal Med. 2021;14(2):253-260. doi: 10.3233/NPM-200595.

DOI:10.3233/NPM-200595

PMID:33074199

Abstract

BACKGROUND

Newborn infants with birth weight less than 1500 grams defining very low birth weight (VLBW) constitute 1.2-1.5% of total live births and 15-20% of all admissions to neonatal units. Advances in antenatal care, care at delivery, and neonatal practice over the past few decades, have substantially improved outcomes in VLBW infants, and reduced neonatal mortality.

METHODS

A retrospective single tertiary care center cohort study of VLBW infants with gestational age between 23-33 weeks admitted to the neonatal intensive care unit (NICU) in King Abdulaziz Medical City, Jeddah (KAMC-J) between January 1, 1994, and December 31, 2019 (26 years). The trends of survival of VLBW infants and major changes in clinical practice of premature care over a period of 26 years were evaluated.

RESULTS

Over a period of 26 years, 1,247 VLBW infants were admitted to the NICU that represents 1.43% (1.25-1.83%) of total live births. 50.80% (n = 634) were male, whereas the 49.2% (n = 613) were female. Among them, 1013 (81.2%) were discharged home alive. There was a significant and progressive improvement in the survival rate of VLBW infants over a 26-year period from 66.83% in period 1 (1994 -1998) to 90.0 % in period 5 (2014 -2019), which represents a 34.67% total improvement rate. The improvement in survival rates was observed in all gestational ages between 23-33 weeks, particularly in infants weighing ≤750 grams and ≤1000 grams, and with gestational age between 23-27 weeks. Infants with a gestational age of ≤26 weeks and birth weight ≤750 grams delivered by cesarean section had a higher survival rate. Moreover, female infants with a gestational age of ≤26 weeks and birth weight ≤750 grams had a higher survival rate compared to males but not statistically significant.

CONCLUSIONS

The survival rate of VLBW infants had improved significantly over the past 26 years (1994 -2019). This is attributed mainly to the improved survival of ELBW infants (<1000 grams) and gestational age of ≤26 weeks.

摘要

背景

出生体重小于 1500 克的新生儿定义为极低出生体重儿（VLBW），占总活产儿的 1.2-1.5%，占所有新生儿入住率的 15-20%。过去几十年中，产前护理、分娩护理和新生儿护理的进步，极大地改善了 VLBW 婴儿的预后，并降低了新生儿死亡率。

方法

这是一项回顾性单中心队列研究，研究对象为 1994 年 1 月 1 日至 2019 年 12 月 31 日期间在沙特吉达阿卜杜勒阿齐兹国王医疗城（KAMC-J）新生儿重症监护病房（NICU）入住的胎龄 23-33 周的 VLBW 婴儿。评估了 26 年来 VLBW 婴儿的存活率趋势以及早产儿护理的主要临床实践变化。

结果

在 26 年期间，共有 1247 名 VLBW 婴儿入住 NICU，占总活产儿的 1.43%（1.25-1.83%）。其中 50.80%（n=634）为男性，49.2%（n=613）为女性。其中，1013 名（81.2%）婴儿存活出院。VLBW 婴儿的存活率在 26 年期间呈显著且渐进式提高，从第 1 期（1994-1998 年）的 66.83%提高到第 5 期（2014-2019 年）的 90.0%，总提高率为 34.67%。在 23-33 周所有胎龄组中均观察到生存率的提高，特别是在体重≤750 克和≤1000 克的婴儿以及胎龄为 23-27 周的婴儿中。胎龄≤26 周且出生体重≤750 克的剖宫产婴儿存活率更高。此外，胎龄≤26 周且出生体重≤750 克的女性婴儿的存活率高于男性，但无统计学意义。