一项关于极低出生体重早产儿治疗的真实世界研究：中国福建省西南部多中心研究。
A real-world study on the treatment of extremely preterm infants: a multi-center study in southwest area of Fujian Province in China.
机构信息
Department of Neonatology, Women and Children's Hospital, School of Medicine, Xiamen university, Xiamen, 361003, China.
Xiamen key laboratory of perinatal-neonatal infection, Xiamen, 361003, China.
出版信息
BMC Pediatr. 2024 Aug 22;24(1):537. doi: 10.1186/s12887-024-05016-2.
BACKGROUND
Due to regional and cultural differences, the current status of extremely preterm infants(EPIs) treatment across different areas of mainland China remains unclear. This study investigated the survival rate and incidence of major diseases among EPIs in the southwest area of Fujian province.
METHOD
This retrospective and multicenter study collected perinatal data from EPIs with gestational ages between 22-27w and born in the southwest area of Fujian province. The study population was divided into 6 groups based on gestational age at delivery. The primary outcome was the survival status at ordered hospital discharge or correct gestational age of 40 weeks, and the secondary outcome was the incidence of major diseases. The study analyzed the actual survival status of EPIs in the area.
RESULT
A total of 2004 preterm infants with gestational ages of 22-27 weeks were enrolled in this study. Among them, 1535 cases (76.6%) were born in the delivery room but did not survive, 469 cases (23.4%) were transferred to the neonatal department for treatment, 101 cases (5.0%) received partial treatment, and 368 cases (18.4%) received complete treatment. The overall all-cause mortality rate was 84.4% (1691/2004). The survival rate and survival rate without major serious disease for EPIs who received complete treatment were 85.1% (313/368) and 31.5% (116/318), respectively. The survival rates for gestational ages 22-22w, 23-23w, 24-24w, 25-25w, 26-26w, and 27-27w were 0%, 0%, 59.1% (13/22), 83% (39/47), 88.8% (87/98), and 89.7% (174/198), respectively. The survival rates without major serious disease were 0%, 0%, 9.1% (2/22), 19.1% (9/47), 27.6% (27/98), and 40.2% (78/194), respectively.
CONCLUSION
The all-cause mortality of EPIs in the southwest area of Fujian Province remains high, with a significant number of infants were given up after birth in the delivery room being the main influencing factor. The survival rate of EPIs who received complete treatment at 25-27 weeks in the NICU was similar to that in developed countries. However, the survival rate without major serious disease was significantly lower compared to high-income countries.
背景
由于地域和文化差异，目前中国大陆不同地区极早产儿（extremely preterm infants，EPIs）的治疗现状尚不清楚。本研究旨在调查福建省西南部地区 EPIs 的生存率和主要疾病的发病情况。
方法
本回顾性多中心研究收集了福建省西南部地区胎龄 22-27 周 EPIs 的围生期数据。根据分娩时的胎龄将研究人群分为 6 组。主要结局为出院时或校正胎龄 40 周时的生存状态，次要结局为主要疾病的发病情况。研究分析了该地区 EPIs 的实际生存状况。
结果
本研究共纳入 2004 例胎龄 22-27 周的早产儿。其中，1535 例（76.6%）在产房出生但未存活，469 例（23.4%）转入新生儿科治疗，101 例（5.0%）接受部分治疗，368 例（18.4%）接受完全治疗。总体全因死亡率为 84.4%（1691/2004）。完全治疗的 EPIs 的总生存率和无严重主要疾病生存率分别为 85.1%（313/368）和 31.5%（116/318）。胎龄 22-22 周、23-23 周、24-24 周、25-25 周、26-26 周和 27-27 周的生存率分别为 0%、0%、59.1%（13/22）、83%（39/47）、88.8%（87/98）和 89.7%（174/198）。无严重主要疾病的生存率分别为 0%、0%、9.1%（2/22）、19.1%（9/47）、27.6%（27/98）和 40.2%（78/194）。
结论
福建省西南部地区 EPIs 的全因死亡率仍然较高，产房放弃治疗是主要影响因素。NICU 中 25-27 周完全治疗的 EPIs 生存率与发达国家相似，但无严重主要疾病的生存率明显低于高收入国家。
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