Dhivar Nirali R, Gandhi Rohankumar, Murugan Yogesh, Vora Hetal
Paediatrics and Child Health, Gujarat Medical Education & Research Society, Gandhinagar, IND.
Community and Family Medicine, Shri M. P. Shah Government Medical College, Jamnagar, IND.
Cureus. 2024 Jun 8;16(6):e61981. doi: 10.7759/cureus.61981. eCollection 2024 Jun.
Low birth weight (LBW) increases infant morbidity and mortality and is a major public health concern, especially in resource-constrained settings. The purpose of this retrospective study was to assess the outcomes and morbidities related to LBW neonates referred to a neonatal intensive care unit (NICU) in Western India.
The present study examined the medical records of newborns weighing less than 2 kg at birth who were admitted to the NICU between September 15, 2016, and September 15, 2017. Data on long-term outcomes, clinical manifestations, morbidities, mortality, and demographic variables were gathered and analyzed. Descriptive statistics were used to present continuous variables as mean and standard deviation (SD), while categorical variables were presented as frequencies and percentages. Bivariate and multivariate logistic regression analyses were carried out to find the association between gestational age and major morbidities among LBW babies.
Of 4710 births, 327 (6.9%) were LBW. The leading morbidities of LBW babies were respiratory distress syndrome (RDS) 153 (46.8%), neonatal jaundice 92 (28%), and septicemia 81 (25%), contributing to 58 (17.7%) deaths. Lower gestational age was associated with significantly higher adjusted odds of RDS (<28 weeks: reference; 28-32 weeks: adjusted odds ratio (AOR) 0.07, 95% confidence interval (CI) 0.01-0.33; ≥37 weeks: AOR 0.001, 95% CI 0.00005-0.02) and RDS-related mortality (28-32 weeks: AOR 0.26, 95% CI 0.06-1.13; ≥37 weeks: AOR 0.07, 95% CI 0.01-0.43). Among 250 successfully discharged cases, at 12 months, 18 (13.7%) had a weight below the 3rd percentile, and 9 (6.8%) failed the neurodevelopmental screening.
LBW infants in this setting experience significant morbidities, mortality, and long-term growth and developmental effects. To alleviate the burden associated with LBW, improved neonatal care facilities, infection control protocols, and focused interventions are essential.
低出生体重增加了婴儿的发病率和死亡率，是一个主要的公共卫生问题，尤其是在资源有限的环境中。这项回顾性研究的目的是评估转诊至印度西部一家新生儿重症监护病房（NICU）的低出生体重新生儿的结局和发病率。
本研究检查了2016年9月15日至2017年9月15日期间入住NICU的出生体重低于2kg的新生儿的病历。收集并分析了有关长期结局、临床表现、发病率、死亡率和人口统计学变量的数据。描述性统计用于将连续变量表示为均值和标准差（SD），而分类变量则表示为频率和百分比。进行双变量和多变量逻辑回归分析以发现低出生体重儿的胎龄与主要发病率之间的关联。
在4710例出生中，327例（6.9%）为低出生体重。低出生体重儿的主要发病情况为呼吸窘迫综合征（RDS）153例（46.8%）、新生儿黄疸92例（28%）和败血症81例（25%），导致58例（17.7%）死亡。较低的胎龄与RDS的调整后较高发病几率显著相关（<28周：参照；28 - 32周：调整优势比（AOR）0.07，95%置信区间（CI）0.01 - 0.33；≥37周：AOR 0.001，95% CI 0.00005 - 0.02）以及与RDS相关的死亡率（28 - 32周：AOR 0.26，95% CI 0.06 - 1.13；≥37周：AOR 0.07，95% CI 0.01 - 0.43）。在250例成功出院的病例中，12个月时，18例（13.7%）体重低于第3百分位数，9例（6.8%）神经发育筛查未通过。
在这种情况下，低出生体重婴儿经历了显著的发病率、死亡率以及长期生长和发育影响。为减轻与低出生体重相关的负担，改善新生儿护理设施、感染控制方案和针对性干预措施至关重要。
