Pulmonary hemorrhage in preterm infants born <29 weeks' gestation: a population cohort study.

IF 4.7 3区医学 Q1 PEDIATRICS

Paediatric Respiratory Reviews Pub Date : 2025-04-09 DOI:10.1016/j.prrv.2025.04.001

Pranav R Jani, Traci-Anne Goyen, James Elhindi, Rajesh Maheshwari, Daphne D'Cruz, Himanshu Popat, Mohamed Abdel-Latif, Melissa Luig, Dharmesh Shah

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引用次数: 0

Abstract

Objective: To evaluate the incidence, clinical characteristics and outcomes of pulmonary hemorrhage (PH) in preterm infants who were born <29 weeks' gestation in relation to their small for gestational age (SGA) status.

Study design: This retrospective cohort study included preterm infants born <29 weeks' gestation and admitted to one of eight tertiary perinatal hospitals in New South Wales and The Australian Capital Territory, Australia from 1 January 2007 to 31 December 2019. Data for analysis was obtained from the Neonatal Intensive Care Units' (NICUs) database. Temporal trends and changes in the outcomes were examined using multivariable logistic regression models.

Results: The median gestational age was 27 weeks' (interquartile range (IR): 25-28) and the median birth weight was 928 g (IR: 756-1,106). PH occurred in 281/4,823 infants (5.8 %). PH more than doubled in SGA compared to appropriately grown infants (11.1 %: 39/353 versus 5.4 %: 242/4,470, difference 5.7; 95 % CI:2.14-9.12) and in infants born <26 weeks compared to ≥26 weeks (137/1,356: 10.1 % versus 144/3,467: 4.2 %, difference 5.9; 95 % CI:4.16-7.63). After confounder adjustments, PH was associated with a higher predischarge mortality (OR:3.97, 95 % CI:3.00-5.24) and severe intraventricular hemorrhage (OR:4.2, 95 % CI:3.10-5.67) but made no difference in levels of functional impairment at 2-3 years corrected age (OR:1.13, 95 % CI:0.77-1.66).

Conclusion: PH was more common in infants born SGA and in those born <26 weeks' gestation. PH was associated with poorer predischarge clinical outcomes. Timely risk prediction is needed to improve outcomes in these infants.

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妊娠<29周的早产儿肺出血：一项人群队列研究

目的：评价出生早产儿肺出血（PH）的发生率、临床特征和结局研究设计：本回顾性队列研究纳入了出生的早产儿。结果：中位胎龄为27周（四分位间距（IR）： 25-28），中位出生体重为928 g （IR: 756- 1106）。4823例婴儿中有281例（5.8%）发生PH。与适当生长的婴儿相比，SGA的PH增加了一倍多(11.1%:39/353 vs 5.4%: 242/4,470，差异5.7；95% CI:2.14-9.12)和出生的婴儿中PH更常见于SGA出生的婴儿和出生的婴儿

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来源期刊

Paediatric Respiratory Reviews 医学-呼吸系统

CiteScore

12.50

自引率

0.00%

发文量

审稿时长

23 days

期刊介绍： Paediatric Respiratory Reviews offers authors the opportunity to submit their own editorials, educational reviews and short communications on topics relevant to paediatric respiratory medicine. These peer reviewed contributions will complement the commissioned reviews which will continue to form an integral part of the journal. Subjects covered include: • Epidemiology • Immunology and cell biology • Physiology • Occupational disorders • The role of allergens and pollutants A particular emphasis is given to the recommendation of "best practice" for primary care physicians and paediatricians. Paediatric Respiratory Reviews is aimed at general paediatricians but it should also be read by specialist paediatric physicians and nurses, respiratory physicians and general practitioners. It is a journal for those who are busy and do not have time to read systematically through literature, but who need to stay up to date in the field of paediatric respiratory and sleep medicine.