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某医院新生儿重症监护病房早产儿脑室内出血的发生率及其危险因素

The Frequency of Intraventricular Hemorrhage and its Risk Factors in Premature Neonates in a Hospital's NICU.

作者信息

Basiri Behnaz, Sabzehei Mohammad Kazem, Shokouhi Solgi Maryam, Khanlarzadeh Elham, Mosheiri Mojdeh

机构信息

Department of neonatology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.

Department of Social Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.

出版信息

Iran J Child Neurol. 2021 Summer;15(3):109-118. doi: 10.22037/ijcn.v15i3.21592.

Abstract

OBJECTIVE

Intra-ventricular hemorrhage (IVH) is the leading cause of mortality and disability in premature neonates. The present study aimed to determine the frequency of IVH and its risk factors in the premature newborns admitted to the Neonatal Intensive Care Unit (NICU)at Fatemieh Hospital in Hamadan, Iran, in 2016.

METHODS & MATERIALS: This retrospective cross-sectional study was conducted on178 neonates with a gestational age of ≤ 32 weeks admitted to Fatemieh Hospital affiliated to the Hamadan University of Medical Sciences, Hamadan, Iran, in 2016. The study population was selected using the census method. The newborns were subjected to cranial ultrasound on the seventh day of life, and they were assigned into two case and control groups (namely neonates with IVH and those without IVH, respectively). Intra- ventricular hemorrhage was classified into four grades regarding Papile classification. The patients' demographic specifications, including 1- and 5-minute Apgar scores, type of delivery, birth weight, use of mechanical ventilation, prenatal corticosteroid, gestational age, and some complications (e.g., Pneumothorax), were collected using a checklist. The data were analyzed using SPSS software version 16.

RESULTS

According to the results, the prevalence of IVH in premature infants admitted to NICU was approximately 20%, and 61.2% of the neonates were male. The participants' mean gestational age was 30.39 weeks. The comparison of delivery type between the case and control groups revealed no significant difference (=0.197). Furthermore, there was a significant difference between the two groups in terms of their need for mechanical ventilation (=0.03), Pneumothorax(=0.001), and 5-minute Apgar scores (=0.04). Moreover, the incidence of IVH had a significant relationship with the mean gestational age (=0.001) and birth weight (=0.04).

CONCLUSION

According to the findings, the premature newborns admitted to the NICU revealed a relatively high prevalence of IVH. The condition is aggravated in preterm neonates by some factors such as low birth weight, 5-minute Apgar score, gestational age, and the need for mechanical ventilation.

摘要

目的

脑室内出血(IVH)是早产新生儿死亡和残疾的主要原因。本研究旨在确定2016年入住伊朗哈马丹法特米耶医院新生儿重症监护病房(NICU)的早产新生儿中IVH的发生率及其危险因素。

方法与材料

本回顾性横断面研究于2016年对178名孕周≤32周的新生儿进行,这些新生儿入住伊朗哈马丹医科大学附属法特米耶医院。研究人群采用普查方法选取。新生儿在出生后第7天接受头颅超声检查,并分为病例组和对照组(分别为有IVH的新生儿和无IVH的新生儿)。根据帕皮勒分类法,脑室内出血分为四个等级。使用检查表收集患者的人口统计学特征,包括1分钟和5分钟阿氏评分、分娩方式、出生体重、机械通气的使用、产前皮质类固醇、孕周以及一些并发症(如气胸)。数据使用SPSS 16.0软件进行分析。

结果

结果显示,入住NICU的早产儿中IVH的患病率约为20%,61.2%的新生儿为男性。参与者的平均孕周为30.39周。病例组和对照组分娩方式的比较显示无显著差异(P=0.197)。此外,两组在机械通气需求(P=0.03)、气胸(P=0.001)和5分钟阿氏评分(P=0.04)方面存在显著差异。此外,IVH的发生率与平均孕周(P=0.001)和出生体重(P=0.04)有显著关系。

结论

根据研究结果,入住NICU的早产新生儿中IVH的患病率相对较高。低出生体重、5分钟阿氏评分、孕周以及机械通气需求等因素会使早产儿的病情加重。

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