Beeram M, Solarin K, Young M, Abedin M
Department of Pediatrics, District of Columbia General Hospital, Washington, DC, USA.
Clin Pediatr (Phila). 1995 Jun;34(6):313-6. doi: 10.1177/000992289503400604.
Recently, a number of infants have been born at home, in an ambulance, car, etc., before arrival at the District of Columbia General Hospital. Many of these infants had poor outcome. To evaluate the prevalence and outcome of these infants, we reviewed medical records of all infants born before arrival at the hospital (out-born infants) and compared them with in-hospital deliveries from July 1988 to June 1992. Data were analyzed using Fisher's Exact Test and chi-square test. There were 151 (1.8%) out-born infants and 8,169 (98.2%) in-born infants during this 4-year period. Infants in both groups were predominantly black (85%). The following were significant differences (P < 0.001) between out-born and in-hospital deliveries, respectively: illicit drug exposure 35% vs 21%; low-birth-weight (< 2,500 g) infants 39% vs 16%; intensive care unit admissions 29% vs 15%; and neonatal deaths per 1,000 live births 80 vs 7. We conclude that there is a twofold increase in the morbidity (required intensive care) and an 11-fold increase in the mortality among out-born infants compared with infants delivered in-hospital. Even though out-born infants were < 2% of the total deliveries, they accounted for 17% of total neonatal mortality.
最近，有许多婴儿在抵达哥伦比亚特区综合医院之前，在家中、救护车上、汽车里等地方出生。这些婴儿中有许多预后不良。为了评估这些婴儿的患病率和预后情况，我们查阅了所有在抵达医院之前出生的婴儿（院外出生婴儿）的病历，并将其与1988年7月至1992年6月在医院内分娩的情况进行了比较。数据采用Fisher精确检验和卡方检验进行分析。在这4年期间，有151名（1.8%）院外出生婴儿和8169名（98.2%）院内出生婴儿。两组婴儿主要都是黑人（85%）。院外出生和院内分娩之间分别存在以下显著差异（P<0.001）：非法药物暴露率分别为35%和21%；低体重（<2500克）婴儿比例分别为39%和16%；重症监护病房收治率分别为29%和15%；每1000例活产儿中的新生儿死亡率分别为80和7。我们得出结论，与在医院内分娩的婴儿相比，院外出生婴儿的发病率（需要重症监护）增加了两倍，死亡率增加了11倍。尽管院外出生婴儿占总分娩数的比例不到2%，但他们却占新生儿总死亡率的17%。
