22-24 孕周出生婴儿自发性肠穿孔的危险因素和流行病学。
Risk factors and epidemiology of spontaneous intestinal perforation among infants born at 22-24 weeks' gestational age.
机构信息
Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
Duke University School of Medicine, Durham, NC, USA.
出版信息
J Perinatol. 2024 Jan;44(1):94-99. doi: 10.1038/s41372-023-01782-6. Epub 2023 Sep 27.
OBJECTIVE
To describe the epidemiology, risk factors, and timing of spontaneous intestinal perforation (SIP) among infants born at 22-24 weeks' gestational age (GA).
STUDY DESIGN
Observational cohort study among infants born at 22-24 weeks' GA in 446 neonatal intensive care units.
RESULTS
We identified 9712 infants, of whom 379 (3.9%) developed SIP. SIP incidence increased with decreasing GA (P < 0.001). Antenatal magnesium (odds ratio (OR) 1.42; 95% confidence interval (CI), 1.09-1.85), antenatal indomethacin (OR 1.40; 95% CI, 1.06-1.85), postnatal indomethacin (OR 1.61; 95% CI, 1.23-2.11), and postnatal hydrocortisone exposure (OR 2.02; 95% CI 1.50-2.73) were associated with SIP. Infants who lost 15-20% (OR 1.77; 95% CI, 1.28-2.44) or >20% (OR 2.04; 95% CI, 1.46-2.85) of birth weight had higher odds of SIP than infants with weight loss <10%.
CONCLUSIONS
Antenatal magnesium exposure, antenatal indomethacin exposure, postnatal hydrocortisone exposure, postnatal indomethacin exposure, and weight loss ≥15% were associated with SIP.
目的
描述 22-24 孕周出生婴儿自发性肠穿孔（SIP）的流行病学、风险因素和发生时间。
研究设计
在 446 个新生儿重症监护病房中，对 22-24 孕周出生的婴儿进行观察性队列研究。
结果
我们确定了 9712 名婴儿，其中 379 名（3.9%）发生了 SIP。SIP 发生率随 GA 降低而增加（P<0.001）。产前使用镁（比值比（OR）1.42；95%置信区间（CI），1.09-1.85）、产前使用吲哚美辛（OR 1.40；95% CI，1.06-1.85）、产后使用吲哚美辛（OR 1.61；95% CI，1.23-2.11）和产后使用氢化可的松（OR 2.02；95% CI 1.50-2.73）与 SIP 相关。与体重减轻<10%的婴儿相比，体重损失 15-20%（OR 1.77；95% CI，1.28-2.44）或>20%（OR 2.04；95% CI，1.46-2.85）的婴儿发生 SIP 的可能性更高。
结论
产前使用镁、产前使用吲哚美辛、产后使用氢化可的松、产后使用吲哚美辛和体重损失≥15%与 SIP 相关。
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