Alhasoon Mohammad
Department of Pediatrics, College of Medicine, Qassim University, Unaizah, SAU.
Cureus. 2024 Feb 19;16(2):e54462. doi: 10.7759/cureus.54462. eCollection 2024 Feb.
Introduction Extremely low birth weight (ELBW) refers to the condition in which an infant is born with a weight of less than one thousand grams (2.2 pounds) at birth. ELBW infants face significant challenges and are at increased risk for various medical complications and developmental issues. ELBW poses unique challenges for infants, families, and healthcare providers. Understanding the causes, consequences, and appropriate management strategies for ELBW is crucial for improving the survival rates of these vulnerable infants. Aim This study aimed to measure the survival rates of ELBW infants in Saudi Arabia and its correlated risk factors. Patients and methods This case-control study was a retrospective chart review analysis of data from King Abdulaziz Medical City (KAMC), a single tertiary care center in Riyadh, Kingdom of Saudi Arabia, and conducted over a four-year period. To estimate the survival rate among all live-birth newborn infants who were born with ELBWs of less than 1000 grams, collected data were tabulated and cleaned in MS Excel, and all data were analyzed using IBM SPSS Statistics for Windows, version 26 (released 2019; IBM Corp., Armonk, New York, United States). Results Two hundred and fifty-six patients were involved. Non-survival rates were 12.9%. In a multivariate regression model, prolonged rupture of membranes (PROM), periventricular leukomalacia (PVL), major intraventricular hemorrhage (IVH), and longer length of stay had increased risks for non-survival, while increasing gestational age, APGAR scores, and cesarean section had decreased risks for non-survival. Survival analysis found that there was a significant mean difference in gestational age (weeks) survival time between normal spontaneous vaginal delivery (NSVD) and cesarean section based on log-rank (Mantel-Cox) (p = 0.008). Conclusion Consistent with the literature, a greater prevalence of ELBW infants survived during hospital stay. Independent risk factors for non-survival include PROM, PVL, major IVH, and long length of stay. Cesarean section, increasing gestational, and APGAR scores were identified as the independent predictors of survival. Prospective studies in nature are required to determine these factors' cause and effect.
引言
极低出生体重（ELBW）是指婴儿出生时体重不足1000克（2.2磅）的情况。极低出生体重儿面临重大挑战，出现各种医学并发症和发育问题的风险增加。极低出生体重对婴儿、家庭和医疗保健提供者构成了独特的挑战。了解极低出生体重的原因、后果及适当的管理策略对于提高这些脆弱婴儿的存活率至关重要。
目的
本研究旨在测量沙特阿拉伯极低出生体重儿的存活率及其相关风险因素。
患者与方法
本病例对照研究是对沙特阿拉伯王国利雅得一家单一的三级医疗中心阿卜杜勒阿齐兹国王医疗城（KAMC）的数据进行的回顾性病历审查分析，研究持续了四年。为了估计所有出生时体重低于1000克的极低出生体重活产新生儿的存活率，收集的数据在MS Excel中制表并清理，所有数据使用IBM SPSS Statistics for Windows 26版（2019年发布；IBM公司，美国纽约州阿蒙克）进行分析。
结果
共纳入256例患者。非存活率为12.9%。在多变量回归模型中，胎膜早破（PROM）、脑室周围白质软化（PVL）、重度脑室内出血（IVH）和住院时间延长增加了非存活风险，而孕周增加、阿氏评分和剖宫产则降低了非存活风险。生存分析发现，基于对数秩（曼特尔 - 考克斯）检验，正常自然阴道分娩（NSVD）和剖宫产之间的孕周（周）生存时间存在显著平均差异（p = 0.008）。
结论
与文献一致，更多的极低出生体重儿在住院期间存活。非存活的独立风险因素包括胎膜早破、脑室周围白质软化、重度脑室内出血和住院时间长。剖宫产、孕周增加和阿氏评分被确定为存活的独立预测因素。需要进行前瞻性研究以确定这些因素的因果关系。
