极早产儿的产后最大体重下降、液体管理和结局。
Postnatal maximal weight loss, fluid administration, and outcomes in extremely preterm newborns.
机构信息
Division of Neonatology, University of Washington/Seattle Children's Hospital, Seattle, WA, USA.
Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine at Baylor College of Medicine, Houston, TX, USA.
出版信息
J Perinatol. 2022 Aug;42(8):1008-1016. doi: 10.1038/s41372-022-01369-7. Epub 2022 Mar 25.
OBJECTIVE
Evaluate maximal weight loss (MWL) and total fluid administration (TFA) association in first week after birth with outcomes among extremely preterm (EP) newborns.
STUDY DESIGN
We performed a retrospective analysis of the Preterm Erythropoietin Neuroprotection Trial evaluating first-week MWL, TFA, and association with in-hospital outcomes.
RESULTS
Among n = 883 included EP neonates, n = 842 survived ≥ 7 days and were included in outcome analyses. MWL between 5% to 15% was associated with decreased odds of necrotizing enterocolitis compared to MWL > 15% (OR 0.49, 95% CI 0.25-0.98). Average TFA > 150 mL/kg birthweight/day was associated with increased odds of necrotizing enterocolitis (OR 3.22, 95% CI 1.40-7.42) and patent ductus arteriosus requiring surgery (OR 2.14, 95% CI 1.10-4.15).
CONCLUSION
MWL between 5% to 15% is a potentially optimal window of MWL. Increasing average TFA in the first week is associated with adverse neonatal outcomes. Prospective studies evaluating MWL and TFA and relationship to outcomes in EP neonates are needed.
CLINICAL TRIAL REGISTRATION
This study is a secondary analysis of pre-existing data from the PENUT Trial Registration: NCT01378273, https://clinicaltrials.gov/ct2/show/NCT01378273 .
目的
评估出生后第一周内最大体重减轻（MWL）和总液体管理（TFA）与极早产儿（EP）新生儿结局的关系。
研究设计
我们对 Preterm Erythropoietin Neuroprotection Trial 进行了回顾性分析，评估了第一周的 MWL、TFA 及其与院内结局的关系。
结果
在纳入的 883 例 EP 新生儿中，有 842 例存活≥7 天并纳入结局分析。与 MWL＞15%相比，MWL 在 5%至 15%之间与坏死性小肠结肠炎的发生几率降低相关（OR 0.49，95%CI 0.25-0.98）。TFA 平均＞150ml/kg 出生体重/天与坏死性小肠结肠炎（OR 3.22，95%CI 1.40-7.42）和需要手术治疗的动脉导管未闭（OR 2.14，95%CI 1.10-4.15）的发生几率增加相关。
结论
MWL 在 5%至 15%之间是一个潜在的最佳 MWL 窗口。出生后第一周内 TFA 平均水平的增加与不良新生儿结局相关。需要前瞻性研究评估 EP 新生儿的 MWL 和 TFA 及其与结局的关系。
临床试验注册
本研究是 PENUT 试验预存数据的二次分析。注册信息：NCT01378273，https://clinicaltrials.gov/ct2/show/NCT01378273。
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