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教学医院中出生时间对极低出生体重儿新生儿发病率和死亡率的影响

The Effect of Birth Hour on Neonatal Morbidity and Mortality in Very-Low Birth Weight Infants in a Teaching Hospital.

作者信息

Houjaghani Hirad, Mohammadi Nasim, Vahedi Zahra, Vafaei Shahi Mohammad, Behmadi Reza

机构信息

Iran University of Medical Sciences Faculty of Medicine, Tehran, Iran.

Growth and Development Research Center, Institute of Endocrionology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran.

出版信息

Turk Arch Pediatr. 2023 Sep;58(5):527-530. doi: 10.5152/TurkArchPediatr.2023.23071.

Abstract

OBJECTIVE

With the increase in the preterm birth rate, the factors influencing mortality and morbidity in very-low-birth weight neonates have gained importance in recent years. The results of available studies on the influence of birth hour on the mortality and morbidity rates of preterm infants are contradictory. Moreover, no study on this topic has been conducted in our region.

MATERIALS AND METHODS

This retrospective cohort study was conducted on 127 very-low-birth weight newborns based on birth hour. The newborns were divided into 2 groups, the first born during working hours (7:00 am to 11:59 pm) and the second born during after-hours care (12-6:59 am). Mortality and major diseases were compared using Statistical Package for the Social Sciences by Fisher's exact tests, Pearson's chi-squared test, and independent t-tests. The statistical significance level for all analyses was set at P < .05 and the CI at 95%.

RESULTS

Based on the results of this study in terms of neonatal mortality and major morbidities such as intraventricular hemorrhage and the need for prolonged mechanical ventilation, no significant difference was found between the 2 groups, but the difference in appearance, pulse, grimace, activity, respiration (APGAR) score at the fifth minute was statistically significant and was lower at the working hours.

CONCLUSION

The results of the study may be due to appropriate allocation of resources, assignment of tasks, and professionalism of care in our study area. Further study is needed to determine the differences in clinical care processes that cause these results.

摘要

目的

随着早产率的上升,近年来影响极低出生体重新生儿死亡率和发病率的因素备受关注。关于出生时间对早产儿死亡率和发病率影响的现有研究结果相互矛盾。此外,我们地区尚未开展关于该主题的研究。

材料与方法

本回顾性队列研究基于出生时间对127例极低出生体重新生儿进行。新生儿被分为两组,第一组在工作时间(上午7:00至晚上11:59)出生,第二组在非工作时间护理期间(凌晨12:00至6:59)出生。使用社会科学统计软件包通过Fisher精确检验、Pearson卡方检验和独立t检验比较死亡率和主要疾病。所有分析的统计学显著性水平设定为P < 0.05,置信区间为95%。

结果

基于本研究在新生儿死亡率和主要疾病如脑室内出血以及长期机械通气需求方面的结果,两组之间未发现显著差异,但在出生后第五分钟的外观、脉搏、面部表情、活动、呼吸(APGAR)评分存在统计学显著差异,且在工作时间较低。

结论

本研究结果可能归因于我们研究区域内资源的合理分配、任务的分配以及护理的专业性。需要进一步研究以确定导致这些结果的临床护理过程中的差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9a74/10543069/395dae5c711d/tap-58-5-527_f001.jpg

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