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极低出生体重儿与超极低出生体重儿的死亡率和发病率差异。

Difference in Mortality and Morbidity Between Extremely and Very Low Birth Weight Neonates.

出版信息

Neonatal Netw. 2022 Aug 1;41(5):257-262. doi: 10.1891/NN-2021-0015.

Abstract

: The aim of the present study was to evaluate the mortality and morbidity of extremely low (ELBW < 1,000 g) and very low birth weight neonates (VLBW: 1,000-1,500 g) hospitalized in a referral NICU of a Children's hospital. : A retrospective study was conducted in records of the Neonatal Unit of a tertiary care Children's hospital in Greece from January 2009 to March 2019. : All neonates with birth weight ≤1,500 grams, who were all outborn, were reviewed. : Mortality and morbidity, including respiratory distress syndrome, bronchopulmonary dysplasia, intraventricular hemorrhage, periventricular leukomalacia, necrotizing enterocolitis, early onset sepsis, late onset sepsis, retinopathy of prematurity (ROP), ROP treated with laser and neurological findings were investigated. : A total of 444 neonates (52 percent males) were analyzed. Among them, 187 (42 percent) were ELBW and 257 (58 percent) were VLBW. The mean gestational age was lower in ELBW neonates compared to VLBW (26.3 ± 2.3 vs. 29.7 ± 2.4 weeks, respectively; < .001). Mortality was significantly higher in ELBW compared to VLBW neonates (26.7 percent vs. 7.0 percent, < .001). Morbidity was significantly higher in ELBW compared to VLBW for respiratory distress syndrome ( < .001), bronchopulmonary dysplasia ( < .001), intraventricular hemorrhage ( < .001), periventricular leukomalacia ( < .001), necrotizing enterocolitis ( = .05), early onset sepsis ( < .001) and late onset sepsis ( = 0.001). Similarly, the incidence of ROP and ROP treated with laser was higher in ELBW compared to VLBW neonates ( < .001). Severe neurological findings during follow-up were more prevalent in ELBW compared to VLBW neonates. Finally, the incidence of eye disorders was higher in ELBW compared to VLBW ( = .05). : Our results confirmed that ELBW have higher mortality and morbidity than VLBW neonates. Efforts should be made in order to ameliorate perinatal and neonatal care to reduce the burden of prematurity.

摘要

本研究旨在评估在一家儿童医院的转诊新生儿重症监护病房(NICU)住院的极低出生体重儿(ELBW<1000 克)和极低出生体重儿(VLBW:1000-1500 克)的死亡率和发病率。

在希腊一家三级儿童保健医院的新生儿科进行了一项回顾性研究,时间为 2009 年 1 月至 2019 年 3 月。

所有出生体重≤1500 克的均为外出出生的新生儿均进行了回顾。

调查了死亡率和发病率,包括呼吸窘迫综合征、支气管肺发育不良、脑室内出血、脑室周围白质软化、坏死性小肠结肠炎、早发性败血症、晚发性败血症、早产儿视网膜病变(ROP)、ROP 激光治疗和神经系统发现。

共分析了 444 名新生儿(男性 52%)。其中,187 名(42%)为 ELBW,257 名(58%)为 VLBW。ELBW 新生儿的平均胎龄明显低于 VLBW(分别为 26.3±2.3 周和 29.7±2.4 周;<0.001)。ELBW 新生儿的死亡率明显高于 VLBW(26.7%对 7.0%;<0.001)。ELBW 新生儿的呼吸窘迫综合征(<0.001)、支气管肺发育不良(<0.001)、脑室内出血(<0.001)、脑室周围白质软化(<0.001)、坏死性小肠结肠炎(=0.05)、早发性败血症(<0.001)和晚发性败血症(=0.001)的发病率明显高于 VLBW。同样,ELBW 新生儿的 ROP 和 ROP 激光治疗的发生率也高于 VLBW 新生儿(<0.001)。ELBW 新生儿在随访期间出现严重神经系统发现的比例明显高于 VLBW 新生儿。最后,ELBW 新生儿眼部疾病的发生率高于 VLBW(=0.05)。

我们的研究结果证实,ELBW 的死亡率和发病率高于 VLBW 新生儿。应努力改善围产期和新生儿护理,以减轻早产的负担。

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