Sun Ling, Bao Yingying, Zhang Hong, Zhu Jiajun
Department of Neonatology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Front Pediatr. 2022 Apr 20;10:869963. doi: 10.3389/fped.2022.869963. eCollection 2022.
To identify infants with very low birth weight at risk of late respiratory diseases after discharge.
This retrospective longitudinal study included 388 preterm infants with gestational age of < 32 weeks and birth weight of < 1,500 g and evaluated perinatal information, assessments performed while in the neonatal intensive care unit, and longitudinal follow-up questionnaire until the corrected gestational age of 18-24 months.
The mean birth weight and gestational age were 1,191.2 ± 191.8 g and 29.1 ± 1.4 weeks, respectively. Sixty-four (16.5%) infants developed late respiratory diseases after discharge to the corrected gestational age of 18-24 months. Univariate analyses showed that gestational age, birth weight, respiratory support, oxygen use, bronchopulmonary dysplasia diagnosed at 36 weeks' postmenstrual age and length of hospital stay were associated with late respiratory diseases. After adjusting for covariates, respiratory support was significantly associated with serious respiratory morbidities to 18-24 months corrected gestational age. With each day of respiratory support, the odds of late respiratory diseases increased by 1.033-fold.
Respiratory support was associated with increased odds of developing late respiratory diseases during early childhood, which may be an early predictor to late respiratory morbidities. Thus, it is imperative to identify a safe and effective strategy to prevent chronic dependency on respiratory support.
识别出生体重极低且出院后有患晚期呼吸系统疾病风险的婴儿。
这项回顾性纵向研究纳入了388例孕周小于32周且出生体重小于1500克的早产儿,评估了围产期信息、在新生儿重症监护病房时进行的评估以及直至矫正胎龄18至24个月的纵向随访问卷。
平均出生体重和孕周分别为1191.2±191.8克和29.1±1.4周。64例(16.5%)婴儿在出院至矫正胎龄18至24个月时出现了晚期呼吸系统疾病。单因素分析显示,孕周、出生体重、呼吸支持、吸氧、在月经龄36周时诊断的支气管肺发育不良以及住院时间与晚期呼吸系统疾病有关。在对协变量进行校正后,呼吸支持与至矫正胎龄18至24个月时的严重呼吸系统疾病显著相关。呼吸支持每增加一天,晚期呼吸系统疾病的几率增加1.033倍。
呼吸支持与儿童早期患晚期呼吸系统疾病的几率增加有关,这可能是晚期呼吸系统疾病的一个早期预测指标。因此,必须确定一种安全有效的策略来预防对呼吸支持的慢性依赖。