Analysis of clinical characteristics and risk factors of poor prognosis in the 124 extremely premature infants

LIU Ying-ying, JIANG Qian-nan, TIAN Bao-li, LIU Xiu-xiang

Chinese Journal of Child Health Care ›› 2022, Vol. 30 ›› Issue (6) : 660-663.

PDF(531 KB)
PDF(531 KB)
Chinese Journal of Child Health Care ›› 2022, Vol. 30 ›› Issue (6) : 660-663. DOI: 10.11852/zgetbjzz2021-0585
Clinical Research

Analysis of clinical characteristics and risk factors of poor prognosis in the 124 extremely premature infants

  • LIU Ying-ying, JIANG Qian-nan, TIAN Bao-li, LIU Xiu-xiang
Author information +
History +

Abstract

Objective To analyze the risk factors of prognosis of extremely premature infants(EPI, <28 weeks) hospitalized in the Neonatal Intensive Care Unit (NICU) of Qingdao Women and Children's Hospital, in order to provide reference for the treatment.Methods Clinical data of 124 cases of EPI enrolled in the NICU of Qingdao Women and Children's Hospital from January 2017 to December 2020 were retrospectively analyzed. Differences between the survival (n=75) group and death group (n=49) were analyzed. Then binary Logistic regression model was established to analyze the risk factors for poor prognosis.Results Among 124 cases, 67 cases (54.0%) were male infants. The birth weight ranged from 680 g to 1 520 g, the gestational age ranged from 24+3 weeks to 27+6 weeks, and the overall survival rate was 60.5%.There were significant differences between the survival group and the death group in 13 indicators, including birth weight, gestational age, twins, antenatal corticosteroids, using pulmonary surfactant, invasive ventilation, non-invasive ventilation, duration of non-invasive ventilation, total oxygen therapy time, complicated with neonatal respiratory distress syndrome, intraventricular hemorrhage, early-onset sepsis, neonatal necrotizing enterocolitis (P<0.05). Multivariate Logistic regression analysis showed intraventricular hemorrhage was risk factors for poor prognosis(OR=5.518, 95%CI:1.186 - 25.685,P=0.029),and non-invasive ventilation was protection factor(OR=0.006, 95%CI:0.001 - 0.051, P<0.001).Conclusions The survival rate of EPI is improving, but there is still a gap from the developed countries. Intraventricular hemorrhage is an important risk factor for the prognosis of EPI. So it is suggested to treat complications effectively in early stage, thereby improving the survival rate of EPI.

Key words

survival rate / extremely premature infants / non-invasive ventilation

Cite this article

Download Citations
LIU Ying-ying, JIANG Qian-nan, TIAN Bao-li, LIU Xiu-xiang. Analysis of clinical characteristics and risk factors of poor prognosis in the 124 extremely premature infants[J]. Chinese Journal of Child Health Care. 2022, 30(6): 660-663 https://doi.org/10.11852/zgetbjzz2021-0585

References

[1] 邵肖梅,叶鸿瑁,丘小汕.实用新生儿学[M].5版.北京:人民卫生出版社,2019.
[2] 早产儿治疗用氧和视网膜病变防治指南专家组.早产儿治疗用氧和视网膜病变防治指南[J].中华儿科杂志,2007,45(9):672-673.
[3] 《新生儿神经病学论坛》专家组.早产儿脑白质损伤诊断、防治与综合管理的专家组意见[J].中华新生儿科杂志,2015,30(3):175-177.
[4] 谢幸,孔北华,段涛.妇产科学[M].9版.北京:人民卫生出版社,2018.
[5] Myrhaug HT, Brurberg KG, Hov L, et al.Survival and impairment of extremely premature infants:A Meta-analysis[J]. Pediatrics,2019,143(2):58.
[6] Su BH, Hsieh WS, Hsu CH, et al. Neonatal outcomes of extremely preterm infants from Taiwan:Comparison with Canada, Japan, and the USA[J]. Pediatr Neonatol,2015, 56(1):46-52.
[7] 中华医学会儿科学分会新生儿学组.中国城市早产儿流行病学初步调查报告[J].中国当代儿科杂志,2005,7(1):25-28.
[8] Stoll BJ, Hansen NI, Bell EF, et al. Neonatal outcomes of extremely preterm infants from the NICHD neonatal research network[J].Pediatrics,2010,126(3):443-456.
[9] 超未成熟儿与超低出生体重儿研究协作组.广东省超未成熟儿与超低出生体重儿临床救治分析[J].中华儿科杂志,2019,57(12):934-942.
[10] 超未成熟儿与超低出生体重儿研究协作组.广东省26家三甲医院新生儿科超未成熟儿与超低出生体重儿的住院费用分析[J].实用医学杂志,2020,36(1):108-114.
[11] Ma L, Liu CQ, Cheah I, et al. Cost is an important factor influencing active management of extremely preterm infants[J]. Acta Paediatr, 2019, 108(1):70-75.
[12] 霍乐颍,黄辉文.超低出生体质量儿与超未成熟儿的临床特点及预后影响因素分析[J].当代医学,2020,26(29):95-98.
[13] 超未成熟儿与超低出生体重儿研究协作组.超未成熟儿与超低出生体重儿临床救治结局分析[J].中华新生儿科杂志,2020,35(2):108-112.
[14] Sweet DG, Carnielli V, Greisen G, et al. European consensus guidelines on the management of respiratory distress syndrome 2019 update[J]. Neonatology, 2019, 115(4):432-450.
[15] 李科纯,钱素云,曾健生.肺表面活性物质治疗急性呼吸窘迫综合征研究现状[J].中国实用儿科杂志,2018,33(6):431-434.
[16] Sardesai S, Biniwale M, Wertheimer F, et al. Evolution of surfactant therapy for respiratory distress syndrome: past, present, and future[J]. Pediatr Res,2017,81(1-2):240-248.
[17] 迟明,梅亚波.新生儿急性呼吸窘迫综合征研究进展[J].中国当代儿科杂志,2018,20(9):724-728.
[18] 超未成熟儿与超低出生体重儿研究协作组.超未成熟儿与超低出生体重儿产前糖皮质激使用情况及其对预后影响的多中心调查[J].中国围产医学杂志,2020,23(5):302-310.
[19] 唐思,高喜容,吴运芹.早产儿颅内出血的危险因素及预防进展[J].中华新生儿科杂志,2020,35(1):65-68.
[20] Su BH, Lin HY, Huang FK, et al. Circulatory management focusing on preventing intraventricular hemorrhage and pulmonary hemorrhage in preterm infants [J]. Pediatr Neonatol, 2016,57 (6):453-462.
[21] 崔银珠,张谦慎,贺红云,等.超未成熟儿的生存状况与预后影响因素分析[J].中国当代儿科杂志,2014,16(6):596-600.
[22] 林颖仪.早产儿脑损伤影像学及脑电图诊断的研究进展[J].临床儿科杂志,2017,35(7):548-552.
PDF(531 KB)

Accesses

Citation

Detail

Sections
Recommended

/