Morsing Eva, Lundgren Pia, Hård Anna-Lena, Rakow Alexander, Hellström-Westas Lena, Jacobson Lena, Johnson Mats, Nilsson Staffan, Ley David, Sävman Karin, Hellström Ann
med dr, överläkare, neonatalvården, Skånes universitetssjukhus Lund.
med dr, överläkare, ögonkliniken, Sahlgrenska universitetssjukhuset, Göteborg.
Lakartidningen. 2023 Mar 8;120:22108.
Children born before 24 gestational weeks had high neonatal morbidity and a majority had one or more neurodevelopmental disorders in addition to somatic diagnoses in childhood. Active Swedish perinatal care of infants with gestational age <24 weeks has resulted in a survival rate of more than 50 percent. Resuscitation of these immature infants is controversial, and some countries offer comfort care only. In a retrospective review of medical files and registries of 399 Swedish infants born before 24 gestational weeks, a majority had severe prematurity-related neonatal diagnoses. In childhood (2-13 years), 75 percent had at least one neurodevelopmental disorder and 88 percent had one or more prematurity-related somatic diagnosis (permanent or transient) that was likely to affect their quality of life. Long-term consequences for surviving infants should be considered in general recommendations as well as in parental information.
孕24周前出生的儿童新生儿发病率很高,大多数儿童除了患有儿童期躯体疾病诊断外,还患有一种或多种神经发育障碍。瑞典对孕龄小于24周的婴儿进行积极围产期护理,使存活率超过了50%。对这些未成熟婴儿进行复苏存在争议,一些国家仅提供舒适护理。在一项对399名孕24周前出生的瑞典婴儿的医疗档案和登记记录的回顾性研究中,大多数婴儿有严重的与早产相关的新生儿诊断。在儿童期(2至13岁),75%的儿童至少患有一种神经发育障碍,88%的儿童有一种或多种可能影响其生活质量的与早产相关的躯体诊断(永久性或暂时性)。在一般建议以及向家长提供的信息中,都应考虑存活婴儿的长期后果。