Mutch L, Newdick M, Lodwick A, Chalmers I
Pediatrics. 1986 Jul;78(1):164-71.
Neonatal survival among very low birth weight infants (less than 1,500 g) has improved dramatically during the last decade. Concern about the quality of life among these survivors has focused mainly on the prevalence of severe motor, sensorineural, and intellectual impairment. This study examined the possible effects of increasing survival on less serious morbidity as evidenced by hospital readmission patterns. The experience of VLBW survivors in a geographically defined population has been compared with that of a randomly selected group of heavier infants. As VLBW infant survival rates improved from 35% to 48% between 1968 to 1972 and 1974 to 1978, the rehospitalization rate before 2 years of age increased from 22% to 27%. In contrast, among heavier infants, rehospitalization rates decreased from 9.8% to 8.9%. The relative risk of readmission associated with VLBW thus increased from 2.2 to 3.0. Although this increase in the overall relative risk of rehospitalization in VLBW infants was not statistically significant, there was a dramatic and statistically significant increase in the relative risk of being readmitted because of structural defects (particularly hernias). Overall, there was a marked decline in the number of days spent in the hospital in both birth weight groups.
在过去十年中，极低出生体重婴儿（低于1500克）的新生儿存活率有了显著提高。对这些幸存者生活质量的关注主要集中在严重运动、感觉神经和智力障碍的患病率上。本研究通过医院再入院模式，探讨了存活率提高对不太严重发病率的可能影响。将地理区域内极低出生体重幸存者的情况与随机选择的一组较重婴儿的情况进行了比较。1968年至1972年与1974年至1978年期间，极低出生体重婴儿的存活率从35%提高到48%，2岁前的再住院率从22%上升至27%。相比之下，较重婴儿的再住院率则从9.8%降至8.9%。因此，与极低出生体重相关的再入院相对风险从2.2增至3.0。尽管极低出生体重婴儿再住院总体相对风险的这一增加在统计学上不显著，但因结构缺陷（尤其是疝气）而再入院的相对风险却出现了显著且具有统计学意义的增加。总体而言，两个出生体重组的住院天数均显著下降。
