南非西开普省一家三级医院极低出生体重新生儿的结局:一项回顾性队列研究

IF 0.2 Q4 PEDIATRICS
G. Musiime, L. Lloyd, M. McCaul, N. V. Zyl, S. Holgate
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引用次数: 2

摘要

背景。极低出生体重新生儿(ELBW;<1 000 g)的新生儿死亡率在南非最高。目标。描述在南澳大利亚州三级医院治疗的低体重新生儿的发病率和死亡率。方法。这是一项回顾性队列研究,包括2016年1月1日至12月31日期间在Tygerberg医院接受治疗的所有活产ELBW新生儿。数据从前瞻性收集的新生儿数据库和患者记录中推断。采用多元逻辑回归和生存分析来确定死亡的危险因素。结果。样本包括256名新生儿。记录的发病率如下:呼吸窘迫综合征(83.2%);支气管肺发育不良(8.2%);脑室内出血(34.5%);脑室周围白质软化(0.6%);坏死性小肠结肠炎(10.5%);早产儿视网膜病变(31.2%)。成活率为63.3%。41%的住院患者死亡是由于极度早产。出生体重是死亡率的重要预测因子(危险比0.99;95%置信区间0.992 - 0.999)。在162名存活到出院的新生儿中,有11名在出院后死亡。结论。低出生体重新生儿的发病率和死亡率仍然很高。为了提高存活率,需要将资源分配给新生儿复苏、表面活性剂治疗和增加重症监护床位的可用性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Outcomes of extremely low-birthweight neonates at a tertiary hospital in the Western Cape, South Africa: A retrospective cohort study
Background. Neonates of extremely low birthweight (ELBW; <1 000 g) have the highest neonatal mortality in South Africa (SA).  Objective. To describe the morbidity and mortality of ELBW neonates treated at a tertiary hospital in SA.  Methods. This was a retrospective cohort study including all live-born ELBW neonates treated at Tygerberg Hospital between 1 January and 31 December 2016. Data were extrapolated from a prospectively collected neonatal database and patient records. Multiple logistic regression and survival analysis were performed to identify risk factors of mortality.  Results. The sample included 256 neonates. The following morbidities were recorded: respiratory distress syndrome (83.2%); bronchopulmonary dysplasia (8.2%); intraventricular haemorrhage (34.5%); periventricular leukomalacia (0.6%); necrotising enterocolitis (10.5%); and retinopathy of prematurity (31.2%). The survival-to-discharge rate was 63.3%. Cause of death was documented as extreme prematurity in 41% of the inpatient deaths. Birthweight was a significant predictor of mortality (hazard ratio 0.99; 95% confidence interval 0.992 - 0.999). Of the 162 neonates who survived until discharge, 11 died following discharge.  Conclusion. Morbidity and mortality rates remain high among ELBW neonates. To improve survival, resources need to be allocated to neonatal resuscitation, surfactant therapy and increasing availability of intensive-care beds.
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来源期刊
CiteScore
0.60
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21
审稿时长
12 weeks
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