Incidence of and risk factors for neonatal morbidity after active perinatal care: extremely preterm infants study in Sweden (EXPRESS)

被引：195

作者：

Austeng, Dordi ^{[1
]}

Blennow, Mats ^{[2
]}

Ewald, Uwe ^{[3
]}

Fellman, Vineta ^{[4
]}

Fritz, Thomas ^{[5
]}

Hellstrom-Westas, Lena ^{[3
]}

Hellstrom, Ann ^{[6
]}

Holmgren, Per Ake ^{[7
]}

Holmstrom, Gerd ^{[8
]}

Jakobsson, Peter ^{[9
]}

Jeppsson, Annika ^{[10
]}

Johansson, Kent ^{[11
]}

Kallen, Karin ^{[12
]}

Lagercrantz, Hugo ^{[13
]}

Laurini, Ricardo ^{[14
]}

Lindberg, Eva ^{[15
]}

Lundqvist, Anita ^{[16
]}

Marsal, Karel ^{[17
]}

Nilstun, Tore ^{[18
]}

Norden-Lindeberg, Solveig ^{[19
]}

Norman, Mikael ^{[20
,21
]}

Olhager, Elisabeth ^{[22
]}

Oestlund, Ingrid ^{[23
]}

Serenius, Fredrik ^{[24
]}

Simic, Marija ^{[25
]}

Sjors, Gunnar ^{[3
]}

Stigson, Lennart ^{[26
]}

Stjernqvist, Karin ^{[27
]}

Stromberg, Bo ^{[3
]}

Tornqvist, Kristina ^{[28
]}

Wennergren, Margareta ^{[5
]}

Wallin, Agneta ^{[29
]}

Westgren, Magnus ^{[30
]}

机构：

[1] Uppsala Univ, Dept Ophthalmol, Uppsala, Sweden

[2] Karolinska Univ Hosp Huddinge, Dept Pediat, Stockholm, Sweden

[3] Uppsala Univ, Dept Pediat, Uppsala, Sweden

[4] Lund Univ, Dept Pediat, S-22100 Lund, Sweden

[5] Sahlgrens Univ Hosp, Dept Obstet & Gynecol, Gothenburg, Sweden

[6] Univ Gothenburg, Sahlgrenska Acad, Dept Ophthalmol, Inst Neurosci & Physiol, Gothenburg, Sweden

[7] Umea Univ Hosp, Dept Clin Sci Obstet & Gynecol, S-90185 Umea, Sweden

[8] Uppsala Univ, Dept Ophthalmol, Uppsala, Sweden

[9] Linkoping Univ, Dept Ophthalmol, S-58183 Linkoping, Sweden

[10] Linkoping Univ, Dept Obstet & Gynecol, S-58183 Linkoping, Sweden

[11] Umea Univ, Dept Ophthalmol, S-90187 Umea, Sweden

[12] Lund Univ, Ctr Reprod Epidemiol, S-22100 Lund, Sweden

[13] Astrid Lindgren Childrens Hosp, Dept Pediat, Karolinska Inst, Stockholm, Sweden

[14] Bodo Cent Hosp, Dept Pathol, Bodo, Norway

[15] Univ Orebro, Dept Pediat, Orebro, Sweden

[16] Lund Univ, Dept Hlth Sci, S-22100 Lund, Sweden

[17] Lund Univ, Dept Obstet & Gynecol, S-22100 Lund, Sweden

[18] Lund Univ, Dept Med Eth, S-22100 Lund, Sweden

[19] Uppsala Univ, Dept Obstet & Gynecol, Uppsala, Sweden

[20] Karolinska Inst, Dept Clin Sci Intervent & Technol, Stockholm, Sweden

[21] Karolinska Univ Hosp, Dept Pediat, Stockholm, Sweden

[22] Linkoping Univ, Dept Pediat, S-58183 Linkoping, Sweden

[23] Univ Orebro, Dept Obstet & Gynecol, Orebro, Sweden

[24] Umea Univ Hosp, Dept Pediat, Umea, Sweden

[25] Karolinska Univ Hosp Solna, Dept Obstet & Gynecol, Stockholm, Sweden

[26] Sahlgrens Univ Hosp, Dept Pediat, Gothenburg, Sweden

[27] Lund Univ, Dept Psychol, S-22100 Lund, Sweden

[28] Lund Univ, Dept Ophthalmol, S-22100 Lund, Sweden

[29] Karolinska Univ, St Erik Eye Hosp, Stockholm, Sweden

[30] Karolinska Univ Hosp Huddinge, Dept Obstet & Gynecol, Stockholm, Sweden

来源：

ACTA PAEDIATRICA | 2010年 / 99卷 / 07期

关键词：

Bronchopulmonary dysplasia; Intraventricular haemorrhage; Necrotizing enterocolitis; Patent ductus arteriosus; Retinopathy of prematurity; BIRTH-WEIGHT INFANTS; GESTATIONAL-AGE; GROWTH OUTCOMES; INTENSIVE-CARE; PREMATURITY; RETINOPATHY; MORTALITY; SURVIVAL; BORN; ABNORMALITIES;

D O I：

10.1111/j.1651-2227.2010.01846.x

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Aims: The aim of this study was to determine the incidence of neonatal morbidity in extremely preterm infants and to identify associated risk factors. Methods: Population based study of infants born before 27 gestational weeks and admitted for neonatal intensive care in Sweden during 2004-2007. Results: Of 638 admitted infants, 141 died. Among these, life support was withdrawn in 55 infants because of anticipation of poor long-term outcome. Of 497 surviving infants, 10% developed severe intraventricular haemorrhage (IVH), 5.7% cystic periventricular leucomalacia (cPVL), 41% septicaemia and 5.8% necrotizing enterocolitis (NEC); 61% had patent ductus arteriosus (PDA) and 34% developed retinopathy of prematurity (ROP) stage >= 3. Eighty-five per cent needed mechanical ventilation and 25% developed severe bronchopulmonary dysplasia (BPD). Forty-seven per cent survived to one year of age without any severe IVH, cPVL, severe ROP, severe BPD or NEC. Tocolysis increased and prolonged mechanical ventilation decreased the chances of survival without these morbidities. Maternal smoking and higher gestational duration were associated with lower risk of severe ROP, whereas PDA and poor growth increased this risk. Conclusion: Half of the infants surviving extremely preterm birth suffered from severe neonatal morbidities. Studies on how to reduce these morbidities and on the long-term health of survivors are warranted.

引用

页码：978 / 992

页数：15

共 45 条

[1] Threshold retinopathy at threshold of viability: the EpiBel study [J].