中等收入国家小于胎龄极早产儿的发病率和死亡率
Morbidity and mortality in small for gestational age very preterm infants in a middle-income country.
作者信息
Mangiza Marcia, Ehret Danielle E Y, Edwards Erika M, Rhoda Natasha, Tooke Lloyd
机构信息
Groote Schuur Hospital, Department of Paediatrics, University of Cape Town, Cape Town, South Africa.
Vermont Oxford Network, Burlington, VT, United States.
出版信息
Front Pediatr. 2022 Aug 9;10:915796. doi: 10.3389/fped.2022.915796. eCollection 2022.
OBJECTIVE
To evaluate the impact of small for gestational age (SGA) on outcomes of very preterm infants at Groote Schuur Hospital (GSH), Cape Town, South Africa.
STUDY DESIGN
Data were obtained from the Vermont Oxford Network (VON) GSH database from 2012 to 2018. The study is a secondary analysis of prospectively collected observational data. Fenton growth charts were used to define SGA as birth weight < 10th centile for gestational age.
RESULTS
Mortality [28.9% vs. 18.5%, adjusted risk ratio (aRR) 2.1, 95% confidence interval (CI) 1.6-2.7], bronchopulmonary dysplasia (BPD; 14% vs. 4.5%, aRR 3.7, 95% CI 2.3-6.1), and late-onset sepsis (LOS; 16.7% vs. 9.6%, aRR 2.3, 95% CI 1.6-3.3) were higher in the SGA than in the non-SGA group.
CONCLUSION
Small for gestational age infants have a higher risk of mortality and morbidity among very preterm infants at GSH. This may be useful for counseling and perinatal management.
目的
评估小于胎龄儿（SGA）对南非开普敦格罗特舒尔医院（GSH）极早产儿结局的影响。
研究设计
数据来自2012年至2018年佛蒙特牛津网络（VON）GSH数据库。该研究是对前瞻性收集的观察性数据的二次分析。采用芬顿生长图表将SGA定义为出生体重低于胎龄的第10百分位数。
结果
小于胎龄儿组的死亡率[28.9%对18.5%，调整风险比（aRR）2.1，95%置信区间（CI）1.6 - 2.7]、支气管肺发育不良（BPD；14%对4.5%，aRR 3.7，95% CI 2.3 - 6.1）和晚发性败血症（LOS；16.7%对9.6%，aRR 2.3，95% CI 1.6 - 3.3）均高于非小于胎龄儿组。
结论
在GSH，小于胎龄的极早产儿有更高的死亡和发病风险。这可能有助于咨询和围产期管理。
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