Delivery room resuscitation and short-term outcomes of extremely preterm and extremely low birth weight infants: a multicenter survey in North China

被引：9

作者：

Li, Shuai-Jun ^{[1
]}

Feng, Qi ^{[1
]}

Tian, Xiu-Ying ^{[2
]}

Zhou, Ying ^{[3
]}

Ji, Yong ^{[4
]}

Li, Yue-Mei ^{[5
]}

Zhai, Shu-Fen ^{[6
]}

Guo, Wei ^{[7
]}

Zhang, Fang ^{[8
]}

Zheng, Rong-Xiu ^{[9
]}

He, Hai-Ying ^{[10
]}

Liu, Xia ^{[11
]}

Wang, Jun-Yi ^{[12
]}

Mei, Hua ^{[13
]}

Wang, Hong-Yun ^{[14
]}

Xie, Hua ^{[15
]}

Zeng, Chao-Mei ^{[16
]}

Ma, Li ^{[17
]}

Zhang, Ping-Ping ^{[18
]}

Li, Jin-Yu ^{[19
]}

Wang, Xiao-Ying ^{[20
]}

Li, Li-Hua ^{[21
]}

Cui, Hong ^{[22
]}

Yang, Shu-Lan ^{[23
]}

Chen, Lu ^{[24
]}

Gu, Xiao-Hong ^{[25
]}

Hu, Yan-Ju ^{[26
]}

Que, Sheng-Shun ^{[27
]}

Sun, Li-Xia ^{[28
]}

Yang, Ming ^{[29
]}

Zhao, Wen-Li ^{[30
]}

Ma, Qiu-Yan ^{[31
]}

Wang, Hai-Juan ^{[32
]}

Guo, Jiu-Ye ^{[33
]}

机构：

[1] Peking Univ First Hosp, Dept Pediat, 1 Xian Men St, Beijing 100034, Peoples R China

[2] Tianjin Cent Hosp Gynecol Obstet, Dept Neonatol, Tianjin 300100, Peoples R China

[3] Peking Univ Third Hosp, Dept Pediat, Beijing 100191, Peoples R China

[4] Childrens Hosp Shanxi, Neonatal Intens Care Unit, Taiyuan 030031, Shanxi, Peoples R China

[5] Hebei Med Univ, Dept Neonatol, Hosp 2, Shijiazhuang 050000, Hebei, Peoples R China

[6] Handan Cent Hosp, Dept Neonatol, Handan 056004, Hebei, Peoples R China

[7] Xingtai Peoples Hosp, Dept Neonatol, Xingtai 054031, Hebei, Peoples R China

[8] Tangshan Maternal & Child Hlth Hosp, Dept Neonatol, Tangshan 071023, Hebei, Peoples R China

[9] Tianjin Med Univ, Dept Pediat, Gen Hosp, Tianjin 300052, Peoples R China

[10] Baogang Third Hosp, Dept Pediat, HongCi Grp, Baotou 014010, Inner Mongolia, Peoples R China

[11] Chengde Med Univ, Dept Neonatol, Affiliated Hosp, Chengde 067000, Hebei, Peoples R China

[12] Tsinghua Univ, Dept Pediat, Hosp 1, Beijing 100016, Peoples R China

[13] Inner Mongolia Med Univ, Dept Neonatol, Affiliated Hosp, Hohhot 010050, Inner Mongolia, Peoples R China

[14] Inner Mongolia Maternal & Child Hlth Hosp, Dept Neonatol, Hohhot 010020, Inner Mongolia, Peoples R China

[15] Chifeng Univ, Dept Neonatol, Affiliated Hosp, Chifeng 024005, Inner Mongolia, Peoples R China

[16] Peking Univ, Dept Pediat, Peoples Hosp, Beijing 100044, Peoples R China

[17] Hebei Childrens Hosp, Dept Neonatol, Shijiazhuang 050000, Hebei, Peoples R China

[18] Tianjin First Cent Hosp, Dept Neonatol, Tianjin 300384, Peoples R China

[19] Peking Union Med Coll Hosp, Dept Pediat, Beijing 100730, Peoples R China

[20] Childrens Hosp Capital Inst Pediat, Dept Neonatol, Beijing 100020, Peoples R China

[21] Capital Med Univ, Dept Pediat, Beijing Luhe Hosp, Beijing 101149, Peoples R China

[22] Capital Med Univ, Dept Pediat, Beijing Friendship Hosp, Beijing 100050, Peoples R China

[23] Chifeng Municipal Hosp, Dept Neonatol, Chifeng 024099, Inner Mongolia, Peoples R China

[24] Capital Med Univ, Beijing Childrens Hosp, Neonatal Ctr, Beijing 100045, Peoples R China

[25] Zhangjiakou Maternal & Child Hlth Hosp, Dept Neonatol, Zhangjiakou 075001, Hebei, Peoples R China

[26] Xing An Meng Hosp Inner Mongolia, Dept Neonatol, Xing An Meng 137499, Inner Mongolia, Peoples R China

[27] Tianjin Med Univ, Dept Neonatol, Hosp 2, Tianjin 300211, Peoples R China

[28] Taiyuan Maternal & Child Hlth Hosp, Dept Neonatol, Taiyuan 030021, Shanxi, Peoples R China

[29] Beijing United Family Hosp, Neonatal Intens Care Unit, Beijing 100016, Peoples R China

[30] PLA Rocket Force Characterist Med Ctr, Dept Gynecol & Pediat, Beijing 100088, Peoples R China

[31] Fenyang Hosp Shanxi, Dept Neonatol, Fenyang 030009, Shanxi, Peoples R China

[32] Baoding Maternal & Child Hlth Hosp, Dept Neonatol, Baoding 071023, Hebei, Peoples R China

[33] Chaoyang Maternal & Child Hlth Hosp Beijing, Dept Pediat, Beijing 100024, Peoples R China

来源：

CHINESE MEDICAL JOURNAL | 2021年 / 134卷 / 13期

关键词：

Extremely preterm; Extremely low birth weight infants; Delivery room resuscitation; Survival rate; BPD; Risk factors; BRONCHOPULMONARY DYSPLASIA; MORTALITY; BORN; VENTILATION; INTUBATION; MORBIDITY; AGE;

D O I：

10.1097/CM9.0000000000001499

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Delivery room resuscitation assists preterm infants, especially extremely preterm infants (EPI) and extremely low birth weight infants (ELBWI), in breathing support, while it potentially exerts a negative impact on the lungs and outcomes of preterm infants. This study aimed to assess delivery room resuscitation and discharge outcomes of EPI and ELBWI in China. Methods: The clinical data of EPI (gestational age [GA] <28 weeks) and ELBWI (birth weight [BW] <1000 g), admitted within 72 h of birth in 33 neonatal intensive care units from five provinces and cities in North China between 2017 and 2018, were analyzed. The primary outcomes were delivery room resuscitation and risk factors for delivery room intubation (DRI). The secondary outcomes were survival rates, incidence of bronchopulmonary dysplasia (BPD), and risk factors for BPD. Results: A cohort of 952 preterm infants were enrolled. The incidence of DRI, chest compressions, and administration of epinephrine was 55.9% (532/952), 12.5% (119/952), and 7.0% (67/952), respectively. Multivariate analysis revealed that the risk factors for DRI were GA <28 weeks (odds ratio [OR], 3.147; 95% confidence interval [CI], 2.082-4.755), BW <1000 g (OR, 2.240; 95% CI, 1.606-3.125), and antepartum infection (OR, 1.429; 95% CI, 1.044-1.956). The survival rate was 65.9% (627/952) and was dependent on GA. The rate of BPD was 29.3% (181/627). Multivariate analysis showed that the risk factors for BPD were male (OR, 1.603; 95% CI, 1.061-2.424), DRI (OR, 2.094; 95% CI, 1.328-3.303), respiratory distress syndrome exposed to >= 2 doses of pulmonary surfactants (PS; OR, 2.700; 95% CI, 1.679-4.343), and mechanical ventilation >= 7 days (OR, 4.358; 95% CI, 2.777-6.837). However, a larger BW (OR, 0.998; 95% CI, 0.996-0.999), antenatal steroid (OR, 0.577; 95% CI, 0.379-0.880), and PS use in the delivery room (OR, 0.273; 95% CI, 0.160-0.467) were preventive factors for BPD (all P < 0.05). Conclusion: Improving delivery room resuscitation and management of respiratory complications are imperative during early management of the health of EPI and ELBWI.

引用

页码：1561 / 1568

页数：8

共 35 条

[1]

[Anonymous], 2007, Preterm Birth: Causes, Consequences, and Prevention

[2] Delivery Room Resuscitation and Short-Term Outcomes in Moderately Preterm Infants [J].

Bajaj, Monika ;

Natarajan, Girija ;

Shankaran, Seetha ;

Wyckoff, Myra ;

Laptook, Abbot R. ;

Bell, Edward F. ;

Stoll, Barbara J. ;

Carlo, Waldemar A. ;

Vohr, Betty R. ;

Saha, Shampa ;

Van Meurs, Krisa P. ;

Sanchez, Pablo J. ;

D'Angio, Carl T. ;

Higgins, Rosemary D. ;

Das, Abhik ;

Newman, Nancy ;

Walsh, Michele C. .

JOURNAL OF PEDIATRICS, 2018, 195 :33-+

[3] Ventilation-Induced Brain Injury in Preterm Neonates: A Review of Potential Therapies [J].

Barton, Samantha K. ;

Tolcos, Mary ;

Miller, Suzanne L. ;

Roehr, Charles Christoph ;

Schmolzer, Georg M. ;

Moss, Timothy J. M. ;

Hooper, Stuart B. ;

Wallace, Euan M. ;

Polglase, Graeme R. .

NEONATOLOGY, 2016, 110 (02) :155-162

[4] Unraveling the Links Between the Initiation of Ventilation and Brain Injury in Preterm Infants [J].

Barton, Samantha K. ;

Tolcos, Mary ;

Miller, Suzie L. ;

Roehr, Charles C. ;

Schmolzer, Georg M. ;

Davis, Peter G. ;

Moss, Timothy J. M. ;

LaRosa, Domenic A. ;

Hooper, Stuart B. ;

Polglase, Graeme R. .

FRONTIERS IN PEDIATRICS, 2015, 3

[5] Decrease in delivery room intubation rates after use of nasal intermittent positive pressure ventilation in the delivery room for resuscitation of very low birth weight infants [J].

Biniwale, Manoj ;

Wertheimer, Fiona .

RESUSCITATION, 2017, 116 :33-38

[6] Behavior Profiles at 2 Years for Children Born Extremely Preterm with Bronchopulmonary Dysplasia [J].

Brumbaugh, Jane E. ;

Bell, Edward F. ;

Grey, Scott F. ;

DeMauro, Sara B. ;

Vohr, Betty R. ;

Harmon, Heidi M. ;

Bann, Carla M. ;

Rysavy, Matthew A. ;

Logan, J. Wells ;

Colaizy, Tarah T. ;

Peralta-Carcelen, Myriam A. ;

McGowan, Elisabeth C. ;

Duncan, Andrea F. ;

Stoll, Barbara J. ;

Das, Abhik ;

Hintz, Susan R. .

JOURNAL OF PEDIATRICS, 2020, 219 :152-+

[7]

Collaborative Study Group for Extremely Preterm and Extremely Low Birth Weight Infants, 2019, Zhonghua Er Ke Za Zhi, V57, P934, DOI 10.3760/cma.j.issn.0578-1310.2019.12.008

[8]

Collaborative Study Group for Extremely Preterm and Extremely Low Birth Weight Infants, 2020, CHIN J NEONATOL, V35, P108, DOI [10.3760/cma.j.issn.2096-2932.2020.02.008, DOI 10.3760/CMA.J.ISSN.2096-2932.2020.02.008]

[9] Impact of Delivery Room Resuscitation on Outcomes up to 18 Months in Very Low Birth Weight Infants [J].

DeMauro, Sara B. ;

Roberts, Robin S. ;

Davis, Peter ;

Alvaro, Ruben ;

Bairam, Aida ;

Schmidt, Barbara .

JOURNAL OF PEDIATRICS, 2011, 159 (04) :546-550

[10] A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants [J].

Fenton, Tanis R. ;

Kim, Jae H. .

BMC PEDIATRICS, 2013, 13

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