英国南威尔士27周后出生的极低出生体重儿（≤1500克）的护理模式和结局趋势

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2025-09-18 DOI:10.1038/s41372-025-02431-w

Lieve Boel, Mirain Davies, Nitin Goel, Ian Paul Morris, Sujoy Banerjee, Vasiliki Makri, Chuen Poon, Anitha James, Mallinath Chakraborty

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引用次数: 0

摘要

目的：分析15年来英国南威尔士27周后出生的极低出生体重儿（VLBW）的结局趋势。研究设计：通过推导多变量logistic回归模型分析临床结果的趋势，并以95%置信区间（95% CI）的优势比（aOR）表示。结果的p值：2007年至2021年间，2321名婴儿被纳入队列。死亡率（aOR 0.941; 95% CI 0.895, 0.988）、重型颅脑损伤（0.937;0.893,0.982）、坏死性小肠结肠炎（0.911;0.862,0.964）、脓毒症（0.949;0.920,0.978）的发生率均有下降。出生时机械通气（0.909;0.888,0.930）、接受表面活性剂（0.920;0.899,0.942）、入院后机械通气（0.940;0.919,0.961）的几率均显著降低。对1797名32周前出生的早产儿的亚组分析表明，研究的所有主要结局都有显著改善。讨论：随着时间的推移，在南威尔士的这个VLBW婴儿队列中，护理模式和结果的趋势有所改善，特别是妊娠32周以下的早产儿。

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Trends of care patterns and outcomes of very low birth weight infants (≤1500 g) born after 27 weeks of gestation in South Wales, UK.

Objective: To analyse trends of outcomes of very low birth weight (VLBW) infants born after 27 weeks of gestation over 15 years in South Wales, UK.

Study design: Trends of clinical outcomes were analysed by deriving multivariable logistic regression models and presented as odds ratios (aOR) with 95% confidence intervals (95% CI). A p-value of <0.05 was considered to be statistically significant.

Results: Between 2007 and 2021, 2321 infants were included in the cohort. There was a decline in the incidence of mortality (aOR 0.941; 95% CI 0.895, 0.988), severe brain injury (0.937; 0.893, 0.982), necrotising enterocolitis (0.911; 0.862, 0.964) and sepsis (0.949; 0.920, 0.978). At birth, odds of mechanical ventilation (0.909; 0.888, 0.930) & receipt of surfactant (0.920; 0.899, 0.942), and mechanical ventilation after admission (0.940; 0.919, 0.961) were significantly reduced. Analysis of a subgroup of 1797 preterm infants born before 32 weeks suggested significant improvement in all major outcomes studied.

Discussion: Trends of care patterns and outcomes improved over time in this cohort of VLBW infants in South Wales, especially preterm infants below 32 weeks of gestation.

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

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.