Wafelman L S, Pollock B H, Kreutzer J, Richards D S, Hutchison A A
Department of Pediatrics, University of Florida College of Medicine, Gainesville, Fla., USA.
Biol Neonate. 1999;75(2):73-81. doi: 10.1159/000014080.
Prognostic factors for survival of 62 fetuses and neonates with nonimmune hydrops fetalis (NIHF) were studied retrospectively. Twenty-eight infants survived >/=28 days which is 45% for all fetuses and newborns diagnosed with NIHF and 61% for liveborns with unresolved NIHF. Univariate analysis identified that mortality was associated with the presence of >/=2 serous cavity effusions and a need for chest compressions at birth. Multivariate logistic regression analysis confirmed that the presence of >/=2 serous cavity effusions was significantly associated with mortality from NIHF <28 days after birth [OR = 48.2 (CI 3.6, 662.9) (p < 0.004)]. We conclude that, compared to published cases from the 1970s and early 1980s, survival of liveborns with NIHF seems improved. The decrease in stillbirths is more notable. The severity of hydrops at birth is the key determinant for survival.
对62例非免疫性胎儿水肿（NIHF）胎儿和新生儿的生存预后因素进行了回顾性研究。28例婴儿存活≥28天，占所有诊断为NIHF的胎儿和新生儿的45%，占出生时NIHF未缓解的活产儿的61%。单因素分析表明，死亡率与≥2处浆膜腔积液的存在以及出生时需要进行胸外按压有关。多因素逻辑回归分析证实，≥2处浆膜腔积液的存在与出生后<28天因NIHF导致的死亡率显著相关[比值比=48.2（可信区间3.6，662.9）（p<0.004）]。我们得出结论，与20世纪70年代和80年代初发表的病例相比，患有NIHF的活产儿的存活率似乎有所提高。死产率的下降更为显著。出生时水肿的严重程度是生存的关键决定因素。
