Short-term outcomes of extremely preterm infants at discharge: a multicenter study from Guangdong province during 2008-2017

被引：35

作者：

Wu, Fan ^{[1
,2
]}

Liu, Guosheng ^{[1
]}

Feng, Zhoushan ^{[2
]}

Tan, Xiaohua ^{[2
]}

Yang, Chuanzhong ^{[3
]}

Ye, Xiaotong ^{[3
]}

Dai, Yiheng ^{[4
]}

Liang, Weiyi ^{[4
]}

Ye, Xiuzhen ^{[5
]}

Mo, Jing ^{[5
]}

Ding, Lu ^{[6
]}

Wu, Benqing ^{[6
]}

Chen, Hongxiang ^{[7
]}

Li, Chiwang ^{[7
]}

Zhang, Zhe ^{[8
]}

Rong, Xiao ^{[8
]}

Shen, Wei ^{[9
]}

Huang, Weimin ^{[9
]}

Yang, Bingyan ^{[10
]}

Lv, Junfeng ^{[10
]}

Huo, Leying ^{[11
]}

Huang, Huiwen ^{[11
]}

Rao, Hongping ^{[12
]}

Yan, Wenkang ^{[12
]}

Yang, Yong ^{[13
]}

Ren, Xuejun ^{[13
]}

Wang, Fangfang ^{[14
]}

Liu, Dong ^{[14
]}

Diao, Shiguang ^{[15
]}

Liu, Xiaoyan ^{[15
]}

Meng, Qiong ^{[16
]}

Wang, Yu ^{[16
]}

Wang, Bin ^{[17
]}

Zhang, Lijuan ^{[17
]}

Huang, Yuge ^{[18
]}

Ao, Dang ^{[18
]}

Li, Weizhong ^{[19
]}

Chen, Jieling ^{[19
]}

Chen, Yanling ^{[20
]}

Li, Wei ^{[20
]}

Chen, Zhifeng ^{[21
]}

Ding, Yueqin ^{[21
]}

Li, Xiaoyu ^{[22
]}

Huang, Yuefang ^{[22
]}

Lin, Niyang ^{[23
]}

Cai, Yangfan ^{[23
]}

Han, Shasha ^{[1
]}

Jin, Ya ^{[1
]}

Wan, Zhonghe ^{[24
]}

Ban, Yi ^{[24
]}

机构：

[1] Jinan Univ, Affiliated Hosp 1, Dept Neonatol, Guangzhou 510630, Guangdong, Peoples R China

[2] Guangzhou Med Univ, Affiliated Hosp 3, Dept Pediat, Guangzhou 510150, Guangdong, Peoples R China

[3] Affiliated Southern Med Univ, Shenzhen Maternal & Child Healthcare Hosp, Dept Neonatol, Shenzhen 518028, Guangdong, Peoples R China

[4] Foshan Maternal & Childs Hosp, Dept Neonatol, Foshan 528000, Guangdong, Peoples R China

[5] Women & Children Hosp Guangdong Prov, Dept Neonatol, Guangzhou 510010, Guangdong, Peoples R China

[6] Shenzhen Peoples Hosp, Dept Neonatol, Shenzhen 518020, Guangdong, Peoples R China

[7] Meizhou Peoples Hosp, Dept Neonatol, Meizhou 514031, Guangdong, Peoples R China

[8] Guangzhou Women & Childrens Med Ctr, Dept Neonatol, Guangzhou 510120, Guangdong, Peoples R China

[9] Southern Med Univ, Nanfang Hosp, Dept Neonatol, Guangzhou 510515, Guangdong, Peoples R China

[10] Boai Hosp Zhongshan, Dept Neonatol, Zhongshan 528400, Guangdong, Peoples R China

[11] Zhuhai Matern & Child Hlth Hosp, Dept Neonatol, Zhuhai 519001, Guangdong, Peoples R China

[12] Huizhou Municipal Cent Hosp, Dept Neonatol, Huizhou 516001, Guangdong, Peoples R China

[13] Dongguan Matern & Child Hlth Hosp, Dept Neonatol, Dongguan 523002, Guangdong, Peoples R China

[14] Sun Yat Sen Univ, Affiliated Jiangmen Hosp, Jiangmen Cent Hosp, Dept Neonatol, Jiangmen 529000, Guangdong, Peoples R China

[15] Yuebei Peoples Hosp, Dept Neonatol, Shaoguan 512026, Guangdong, Peoples R China

[16] Guangdong Second Prov Peoples Hosp, Dept Neonatol, Guangzhou 510317, Guangdong, Peoples R China

[17] Southern Med Univ, Zhujiang Hosp, Dept Pediat, Guangzhou 510280, Guangdong, Peoples R China

[18] Guangdong Med Univ, Affiliated Hosp, Dept Pediat, Zhanjiang 524001, Guangdong, Peoples R China

[19] Shantou Univ, Med Coll, Affiliated Hosp 2, Dept Neonatol, Shantou 515041, Guangdong, Peoples R China

[20] Jinan Univ, Affiliated Dongguan Hosp, Med Coll, Dept Neonatol, Dongguan 523900, Guangdong, Peoples R China

[21] Dongguan Peoples Hosp, Dept Pediat, Dongguan 523000, Guangdong, Peoples R China

[22] Sun Yat Sen Univ, Affiliated Hosp 1, Dept Neonatol, Guangzhou 510080, Guangdong, Peoples R China

[23] Shantou Univ, Med Coll, Affiliated Hosp 1, Dept Neonatol, Shantou 515041, Guangdong, Peoples R China

[24] Nanhai Dist Peoples Hosp Foshan, Dept Neonatol, Foshan 528200, Guangdong, Peoples R China

[25] Huadu Dist Peoples Hosp Guangzhou, Dept Neonatol, Guangzhou 510800, Guangdong, Peoples R China

[26] First Peoples Hosp Zhaoqing, Dept Pediat, Zhaoqing 526020, Guangdong, Peoples R China

来源：

BMC PEDIATRICS | 2019年 / 19卷 / 01期

关键词：

Extremely preterm infant; Low birth weight; Survival rate; Complication; Outcome; China; BIRTH-WEIGHT INFANTS; TRENDS; CARE; MORBIDITY; MORTALITY; CANADA; RATES;

D O I：

10.1186/s12887-019-1736-8

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Background An increasing number of extremely preterm (EP) infants have survived worldwide. However, few data have been reported from China. This study was designed to investigate the short-term outcomes of EP infants at discharge in Guangdong province. Methods A total of 2051 EP infants discharged from 26 neonatal intensive care units during 2008-2017 were enrolled. The data from 2008 to 2012 were collected retrospectively, and from 2013 to 2017 were collected prospectively. Their hospitalization records were reviewed. Results During 2008-2017, the mean gestational age (GA) was 26.68 +/- 1.00 weeks and the mean birth weight (BW) was 935 +/- 179 g. The overall survival rate at discharge was 52.5%. There were 321 infants (15.7%) died despite active treatment, and 654 infants (31.9%) died after medical care withdrawal. The survival rates increased with advancing GA and BW (p < 0.001). The annual survival rate improved from 36.2% in 2008 to 59.3% in 2017 (p < 0.001). EP infants discharged from hospitals in Guangzhou and Shenzhen cities had a higher survival rate than in others (p < 0.001). The survival rate of EP infants discharged from general hospitals was lower than in specialist hospitals (p < 0.001). The major complications were neonatal respiratory distress syndrome, 88.0% (1804 of 2051), bronchopulmonary dysplasia, 32.3% (374 of 1158), retinopathy of prematurity (any grade), 45.1% (504 of 1117), necrotizing enterocolitis (any stage), 10.1% (160 of 1588), intraventricular hemorrhages (any grade), 37.4% (535 of 1431), and blood culture-positive nosocomial sepsis, 15.7% (250 of 1588). The multivariate logistic regression analysis indicated that improved survival of EP infants was associated with discharged from specialist hospitals, hospitals located in high-level economic development region, increasing gestational age, increasing birth weight, antenatal steroids use and a history of premature rupture of membranes. However, twins or multiple births, Apgar <= 7 at 5 min, cervical incompetence, and decision to withdraw care were associated with decreased survival. Conclusions Our study revealed the short-term outcomes of EP infants at discharge in China. The overall survival rate was lower than the developed countries, and medical care withdrawal was a serious problem. Nonetheless, improvements in care and outcomes have been made annually.

引用

页数：11

共 29 条

[1] Using a Count of Neonatal Morbidities to Predict Poor Outcome in Extremely Low Birth Weight Infants: Added Role of Neonatal Infection [J].

Bassler, Dirk ;

Stoll, Barbara J. ;

Schmidt, Barbara ;

Asztalos, Elizabeth V. ;

Roberts, Robin S. ;

Robertson, Charlene M. T. ;

Sauve, Reg S. .

PEDIATRICS, 2009, 123 (01) :313-318

[2] NEONATAL NECROTIZING ENTEROCOLITIS - THERAPEUTIC DECISIONS BASED UPON CLINICAL STAGING [J].

BELL, MJ ;

TERNBERG, JL ;

FEIGIN, RD ;

KEATING, JP ;

MARSHALL, R ;

BARTON, L ;

BROTHERTON, T .

ANNALS OF SURGERY, 1978, 187 (01) :1-7

[3] Trends and centre-to-centre variability in survival rates of very preterm infants (<32 weeks) over a 10-year-period in Switzerland [J].

Berger, Thomas M. ;

Steurer, Martina A. ;

Woerner, Andreas ;

Meyer-Schiffer, Philipp ;

Adams, Mark .

ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION, 2012, 97 (05) :F323-F328

[4]

Bhakta KY., 2012, Respiratory Distress Syndrome. Manual of Neonatal care, V7th, P406

[5] National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications [J].

Blencowe, Hannah ;

Cousens, Simon ;

Oestergaard, Mikkel Z. ;

Chou, Doris ;

Moller, Ann-Beth ;

Narwal, Rajesh ;

Adler, Alma ;

Garcia, Claudia Vera ;

Rohde, Sarah ;

Say, Lale ;

Lawn, Joy E. .

LANCET, 2012, 379 (9832) :2162-2172

[6] Preterm infant outcomes in New South Wales and the Australian Capital Territory [J].

Bolisetty, Srinivas ;

Legge, Nele ;

Bajuk, Barbara ;

Lui, Kei .

JOURNAL OF PAEDIATRICS AND CHILD HEALTH, 2015, 51 (07) :713-721

[7] Short term outcomes after extreme preterm birth in England: comparison of two birth cohorts in 1995 and 2006 (the EPICure studies) [J].

Costeloe, Kate L. ;

Hennessy, Enid M. ;

Haider, Sadia ;

Stacey, Fiona ;

Marlow, Neil ;

Draper, Elizabeth S. .

BMJ-BRITISH MEDICAL JOURNAL, 2012, 345

[8] Mortality, Neonatal Morbidity and Two Year Follow-Up of Extremely Preterm Infants Born in the Netherlands in 2007 [J].

de Waal, Cornelia G. ;

Weisglas-Kuperus, Nynke ;

van Goudoever, Johannes B. ;

Walther, Frans J. .

PLOS ONE, 2012, 7 (07)

[9] Outcomes at Age 2 Years of Infants < 28 Weeks' Gestational Age Born in Victoria in 2005 [J].

Doyle, Lex W. ;

Roberts, Gehan ;

Anderson, Peter J. .

JOURNAL OF PEDIATRICS, 2010, 156 (01) :49-U84

[10] Evaluation of neonatal intensive care for extremely low birth weight infants in Victoria over two decades: I. Effectiveness [J].

Doyle, LW .

PEDIATRICS, 2004, 113 (03) :505-509

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