Mohsen A A Farghaly, Mahmoud A M Ali, Ceyda Acun, Vanishree Nandakumar, Hatem Eltaly, Mohamed A Mohamed, Hany Aly
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引用次数: 0
摘要
目的:评估不同胎龄(GA)类别新生儿气胸患病率,确定相关变量,并检查气泡CPAP (b-CPAP)实施的影响。研究设计:对在三家医院出生6年以上的58,706名婴儿进行队列分析,按GA分组:≥35周、29-34周和≤28周。气胸病例与对照组相匹配,并比较采用b-CPAP前后的患病率。结果:气胸发生率为310例(0.53%),≥35周为0.39%,29-34周为4.0%,≤28周为4.6%。大多数病例发生在出生24小时内,特别是≥35周(76%)。≥35周组,气胸与男性、绒毛膜羊膜炎和产房CPAP相关。在29-34周的组中,它与胎龄小、母亲糖尿病和表面活性剂的使用有关。在≤28周的婴儿中,产房插管是主要危险因素。实施b-CPAP后,非插管婴儿气胸患病率没有变化(0.35% vs. 0.41%; aOR = 0.85, 95% CI: 0.62-1.16; P = 0.35)。结论:产房干预与新生儿气胸相关,而非NICU b-CPAP的使用。
Pneumothorax in newborns: a cohort study from three NICUs.
Objective: To assess pneumothorax prevalence in neonates across gestational age (GA) categories, identify associated variables, and examine the impact of bubble CPAP (b-CPAP) implementation.
Study design: A cohort of 58,706 infants born at three hospitals over six years was analyzed, grouped by GA: ≥35 weeks, 29-34 weeks, and ≤28 weeks. Pneumothorax cases were matched with controls, and prevalence before and after b-CPAP adoption was compared.
Results: Pneumothorax occurred in 310 infants (0.53%): 0.39% in ≥35 weeks, 4.0% in 29-34 weeks, and 4.6% in ≤28 weeks GA. Most cases occurred within 24 hours of birth, especially in ≥35 weeks (76%). In the ≥35-week group, pneumothorax was associated with male sex, chorioamnionitis, and delivery room CPAP. In the 29-34-week group, it was linked to small for gestational age, maternal diabetes, and surfactant use. In ≤28-week infants, delivery room intubation was the primary risk factor. Pneumothorax prevalence in non-intubated infants was unchanged after b-CPAP implementation (0.35% vs. 0.41%; aOR = 0.85, 95% CI: 0.62-1.16; P = 0.35).
Conclusion: Delivery room interventions, not NICU b-CPAP use, were associated with neonatal pneumothorax.
期刊介绍:
The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development.
The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.