Finello K M, Litton K M, deLemos R, Chan L S
Department of Pediatrics, University of Southern California Center for Pediatric Health Outcomes Research, University of Southern California, Los Angeles 90033, USA.
J Perinatol. 1998 Sep-Oct;18(5):365-71.
To evaluate factors contributing to optimal medical outcomes during the first year following discharge of very low birth weight infants from tertiary neonatal intensive care units.
This was a prospective investigation of the health and development of 81 very low birth weight infants following discharge from two tertiary neonatal intensive care units in Los Angeles. Infants were assigned to four groups receiving a variety of after care services in their homes. Analyses of variance were computed to examine differences between groups for a variety of outcomes.
No statistically significant differences were seen between after care groups on use of hospital emergency rooms (ER) rehospitalization rates, or child abuse and neglect. Highest overall rates of optimal outcomes were seen in the group receiving the highest intensity of after care services. Those groups receiving long-term home visiting services had significantly higher rates of up-to-date immunizations.
There was no significant impact on infant mortality and morbidity of early discharge, regardless of the system of after care used. However, those infants who received the highest level of after care services had the most optimal health outcomes and were most likely to be receiving well-baby care. It is likely that the comprehensive, clinic-based system of health care available to all study infants was a significant factor in low rates of morbidity.
评估极低出生体重儿从三级新生儿重症监护病房出院后第一年实现最佳医疗结局的相关因素。
这是一项对洛杉矶两家三级新生儿重症监护病房出院的81名极低出生体重儿的健康和发育情况进行的前瞻性调查。婴儿被分为四组，在家中接受各种后续护理服务。计算方差分析以检验不同组在各种结局方面的差异。
在使用医院急诊室、再次住院率或虐待及忽视儿童方面，各后续护理组之间未观察到统计学上的显著差异。在接受最高强度后续护理服务的组中，总体最佳结局发生率最高。那些接受长期家访服务的组，最新免疫接种率显著更高。
无论采用何种后续护理系统，早期出院对婴儿死亡率和发病率均无显著影响。然而，那些接受最高水平后续护理服务的婴儿健康结局最佳，且最有可能接受健康婴儿护理。所有研究婴儿均可获得的基于诊所的综合医疗保健系统很可能是发病率低的一个重要因素。
