La Pine T R, Jackson J C, Bennett F C
Department of Pediatrics, University of Utah Medical Center, Salt Lake City, USA.
Pediatrics. 1995 Sep;96(3 Pt 1):479-83.
Mortality and neurodevelopmental morbidity among infants weighing less than 800 g at birth are compared in three separate studies from the same intensive care nursery during an almost 15-year period.
The survival and neurodevelopmental outcome of 210 infants with birth weights less than 800 g admitted to the University of Washington neonatal intensive care unit between 1986 and 1990 are compared with those of two previous cohorts (1977 through 1980 and 1983 through 1985) of extremely low birth weight (ELBW) infants from the same nursery.
Annual admissions of these ELBW infants nearly doubled from 1977 to 1990, whereas nursery survival rose from 20% between 1977 and 1980, to 36% between 1983 and 1985, to 49% in this current study of births between 1986 and 1990. The greatest increase in survival among the three studies occurred among infants with birth weights less than 700 g. Female survival was 20% higher than male survival in each of the time periods. The prevalence of major neurosensory impairments did not differ significantly among the three study groups (19%, 21%, and 22% respectively); male survivors were more commonly affected across time periods. There were no differences in mean cognitive test scores between the current 1986 through 1990 birth cohort (94) and the two previous cohorts (1977 through 1980, 98; 1983 through 1985, 89).
The experience of our center with these ELBW infants over time seems reassuring to the extent that progressive increases in nursery survival have not resulted in increased neurodevelopmental morbidity.
在近15年的时间里，对来自同一重症监护病房的三项独立研究中出生体重小于800克的婴儿的死亡率和神经发育发病率进行比较。
将1986年至1990年期间入住华盛顿大学新生儿重症监护病房的210名出生体重小于800克的婴儿的生存情况和神经发育结局，与同一病房之前的两组极低出生体重（ELBW）婴儿队列（1977年至1980年和1983年至1985年）进行比较。
从1977年到1990年，这些ELBW婴儿的年度入院人数几乎翻了一番，而病房存活率从1977年至1980年的20%，升至1983年至1985年的36%，在本次1986年至1990年出生的婴儿研究中达到49%。三项研究中存活率增长最大的是出生体重小于700克的婴儿。在每个时间段，女性存活率均比男性存活率高20%。三个研究组的主要神经感觉障碍患病率无显著差异（分别为19%、21%和22%）；在各个时间段，男性幸存者受影响更为常见。1986年至1990年出生队列的平均认知测试得分（94分）与前两组队列（1977年至1980年，98分；1983年至1985年，89分）之间没有差异。
随着时间推移，我们中心对这些ELBW婴儿的治疗经验似乎令人安心，因为病房存活率的逐步提高并未导致神经发育发病率增加。
