Khasawneh Wasim, Khriesat Wadah
Department of Pediatrics and Neonatology, Faculty of Medicine, Jordan University of Science and Technology, Jordan.
Ann Med Surg (Lond). 2020 Oct 17;60:44-49. doi: 10.1016/j.amsu.2020.10.017. eCollection 2020 Dec.
Prematurity is a major cause of neonatal morbidity and mortality. The aim of this study is to assess the rate of prematurity and determine the mortality rate and short-term outcomes among premature infants admitted at King Abdullah University Hospital (KAUH) in Jordan.
A retrospective cross-sectional review of all premature infants admitted at KAUH between August 2016 and August 2018 was conducted. Collected data include characteristics, medical interventions, morbidities, mortality, and discharge outcomes. Included infants were divided into two groups: less than 32-week gestation (group 1) and ≥32-week gestation (group 2). The outcomes were compared between both groups and reported accordingly.
Out of 7020 newborns, 1102 were delivered before 37-week gestation, representing a prematurity rate of 15.7%. The mean gestational age and birth weight were 33.8 weeks and 2116 grams respectively. Group 1 comprised 13%. Late preterm infants (gestational age 34 to 36 6/7 weeks) accounted for 74%. The mortality rate was 4.6%. More infants died from group 1 (29% vs. 1.5%, p < 0.05). Group 1 infants had higher rates of respiratory distress syndrome (92% vs. 30%), bronchopulmonary dysplasia (28.4% vs. 1.1%), severe intraventricular hemorrhage (5.9% vs. 0.1%), high-stage retinopathy of prematurity (6.6% vs. 0.2%), necrotizing enterocolitis (9.2% vs. 0%), and sepsis (18.4% vs. 2.1%). At discharge, there was a significant difference in the length of stay, corrected gestational age, and weight in favor of group 2 (p < 0.05).
Although high rate of prematurity was observed, the majority were late preterm with reassuring outcomes. Compared with >32-week infants, the mortality and short-term complications were more frequent among those born before 32 weeks. Still, the overall mortality rate and risk of morbidities were reasonable. Population-based analysis of the risk factors among the more vulnerable very preterm and extremely premature infants is recommended to better understand the outcomes.
早产是新生儿发病和死亡的主要原因。本研究的目的是评估约旦阿卜杜拉国王大学医院（KAUH）收治的早产儿的早产率，并确定死亡率和短期预后。
对2016年8月至2018年8月期间在KAUH收治的所有早产儿进行回顾性横断面研究。收集的数据包括特征、医疗干预、发病率、死亡率和出院结局。纳入的婴儿分为两组：孕周小于32周（第1组）和孕周≥32周（第2组）。比较两组的结局并相应报告。
在7020例新生儿中，1102例在孕37周前分娩，早产率为15.7%。平均孕周和出生体重分别为33.8周和2116克。第1组占13%。晚期早产儿（孕周34至36 6/7周）占74%。死亡率为4.6%。第1组死亡的婴儿更多（29%对1.5%，p<0.05）。第1组婴儿呼吸窘迫综合征（92%对30%）、支气管肺发育不良（28.4%对1.1%）、重度脑室内出血（5.9%对0.1%）、高阶段早产儿视网膜病变（6.6%对0.2%）、坏死性小肠结肠炎（9.2%对0%）和败血症（18.4%对2.1%）的发生率更高。出院时，住院时间、矫正孕周和体重方面存在显著差异，有利于第2组（p<0.05）。
尽管观察到早产率较高，但大多数是晚期早产，结局令人安心。与孕周>32周的婴儿相比，孕周<32周出生的婴儿死亡率和短期并发症更频繁。不过，总体死亡率和发病风险是合理的。建议对更脆弱的极早产儿和超早产儿进行基于人群的危险因素分析，以更好地了解结局。
