Rubaltelli F F, Dani C, Reali M F, Bertini G, Wiechmann L, Tangucci M, Spagnolo A
Department of Pediatrics, University of Florence School of Medicine, Italy.
Acta Paediatr. 1998 Dec;87(12):1261-8. doi: 10.1080/080352598750030951.
A prospective multicentre 12-month survey of neonatal respiratory disorders in 63 537 Italian infants was performed to evaluate the incidence of acute neonatal respiratory disorders and of the main related complications. A total of 1427 developed respiratory disorders (2.2%), 208 of whom died (14.6%). The incidence of respiratory distress syndrome was 1.16%, with a case fatality rate (CFR) of 24%; that of transient tachypnoea was 0.93%, with a CFR of 1.3%. The rates of meconium aspiration syndrome, persistent pulmonary hypertension and pneumonia were 0.06%, 0.02% and 0.07%, with CFRs of 10.3%, 38.5% and 21.7%, respectively. The occurrences of the main complications in affected newborns were: bronchopulmonary dysplasia 5.6%, necrotizing enterocolitis 1.7%, patent ductus arteriosus 9.8%, 3 degrees and 4 degrees grade intraventricular haemorrhage 6.8% and air leak 4.9%. It was concluded that the incidence of acute neonatal respiratory disorders and the main related complications was lower than that reported two decades ago and that the CFR of acute neonatal respiratory disorders had increased. These results may be the consequences of (i) progress in the management of high-risk pregnancies, (ii) an increased number of viable infants with extremely low birth weight and (iii) diffusion of antenatal treatment with corticosteroids which, in this series, seemed to reduce the morbidity but not the mortality in the high-risk infants.
对63537名意大利婴儿进行了一项为期12个月的前瞻性多中心新生儿呼吸系统疾病调查，以评估急性新生儿呼吸系统疾病及其主要相关并发症的发病率。共有1427名婴儿出现呼吸系统疾病（2.2%），其中208名死亡（14.6%）。呼吸窘迫综合征的发病率为1.16%，病死率（CFR）为24%；短暂性呼吸急促的发病率为0.93%，CFR为1.3%。胎粪吸入综合征、持续性肺动脉高压和肺炎的发病率分别为0.06%、0.02%和0.07%，CFR分别为10.3%、38.5%和21.7%。受影响新生儿主要并发症的发生率为：支气管肺发育不良5.6%，坏死性小肠结肠炎1.7%，动脉导管未闭9.8%，3级和4级脑室内出血6.8%，气漏4.9%。得出的结论是，急性新生儿呼吸系统疾病及其主要相关并发症的发病率低于二十年前报告的发病率，且急性新生儿呼吸系统疾病的CFR有所增加。这些结果可能是以下因素导致的：（i）高危妊娠管理方面的进展；（ii）极低出生体重存活婴儿数量增加；（iii）产前使用皮质类固醇治疗的普及，在本系列研究中，这似乎降低了高危婴儿的发病率，但并未降低死亡率。
