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英国南威尔士妊娠27周后出生的极低出生体重儿(≤1500克)的护理模式及结局趋势

Trends of care patterns and outcomes of very low birth weight infants (≤1500 g) born after 27 weeks of gestation in South Wales, UK.

作者信息

Boel Lieve, Davies Mirain, Goel Nitin, Morris Ian Paul, Banerjee Sujoy, Makri Vasiliki, Poon Chuen, James Anitha, Chakraborty Mallinath

机构信息

Regional Neonatal Intensive Care Unit, University Hospital of Wales, Cardiff, UK.

School of Medicine, Cardiff University, Cardiff, UK.

出版信息

J Perinatol. 2025 Sep 18. doi: 10.1038/s41372-025-02431-w.

Abstract

OBJECTIVE

To analyse trends of outcomes of very low birth weight (VLBW) infants born after 27 weeks of gestation over 15 years in South Wales, UK.

STUDY DESIGN

Trends of clinical outcomes were analysed by deriving multivariable logistic regression models and presented as odds ratios (aOR) with 95% confidence intervals (95% CI). A p-value of <0.05 was considered to be statistically significant.

RESULTS

Between 2007 and 2021, 2321 infants were included in the cohort. There was a decline in the incidence of mortality (aOR 0.941; 95% CI 0.895, 0.988), severe brain injury (0.937; 0.893, 0.982), necrotising enterocolitis (0.911; 0.862, 0.964) and sepsis (0.949; 0.920, 0.978). At birth, odds of mechanical ventilation (0.909; 0.888, 0.930) & receipt of surfactant (0.920; 0.899, 0.942), and mechanical ventilation after admission (0.940; 0.919, 0.961) were significantly reduced. Analysis of a subgroup of 1797 preterm infants born before 32 weeks suggested significant improvement in all major outcomes studied.

DISCUSSION

Trends of care patterns and outcomes improved over time in this cohort of VLBW infants in South Wales, especially preterm infants below 32 weeks of gestation.

摘要

目的

分析英国南威尔士15年间孕27周后出生的极低出生体重(VLBW)婴儿的结局趋势。

研究设计

通过推导多变量逻辑回归模型分析临床结局趋势,并以比值比(aOR)及95%置信区间(95%CI)呈现。p值<0.05被认为具有统计学意义。

结果

2007年至2021年期间,该队列纳入了2321名婴儿。死亡率(aOR 0.941;95%CI 0.895,0.988)、重度脑损伤(0.937;0.893,0.982)、坏死性小肠结肠炎(0.911;0.862,0.964)和败血症(0.949;0.920,0.978)的发生率均有所下降。出生时,机械通气(0.909;0.888,0.930)及接受表面活性剂治疗(0.920;0.899,0.942)的几率,以及入院后机械通气(0.940;0.919,0.961)的几率均显著降低。对1797名孕32周前出生的早产儿亚组的分析表明,所有研究的主要结局均有显著改善。

讨论

在南威尔士的这组极低出生体重婴儿中,尤其是孕32周以下的早产儿,护理模式和结局趋势随时间有所改善。

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