Characteristics and prognosis of neonatal pneumothorax: a clinical analysis of 150 cases / 国际儿科学杂志

ABSTRACT

Objective:To investigate the clinical characteristics of different gestational ages in neonatal pneumothorax and the influencing factors of adverse outcomes.Methods:Newborns with pneumothorax hospitalized in the neonatal intensive care unit, the division of neonatology of Shengjing hospital, China Medical University from Jan.2012 to Dec.2018 were included.Babies were divided into both premature group and full-term group according to gestational age(GA), and survival group and death group according to the outcomes.Multivariate logistic regression analysis was used to explore the influencing factors of death from pneumothorax in neonates.Results:150 children were included, of them 101 males, 49 females(2.06 1), 103 outborn(68.7%)and 123 unilateral pneumothorax(82.0%). The overall mortality was 9.3%(14/150). There were 60 premature infants with gestational age(GA)28~36w and birth weight(BW)624~4 000 g, 5(8.3% in the premature group)died, and the other 90 were full-term infants with GA37~42w, BW2 650~4 700 g, 9(10.0% in the fullterm group)died.The rates of premature rupture of membranes(26.7%), resuscitation(26.7%), pulmonary surfactant(PS)(30.0%)and mechanical ventilation before pneumothorax(56.7%)in the preterm group were significantly higher than that in the term group(12.2%, 13.3%, 3.3% and 26.7%, P<0.05). Premature rupture of membranes more than 24 h( OR=1.230, 95% CI 3.800~3.940, P<0.05), mechanical ventilation( OR=2.491, 95% CI 1.322~4.694, P<0.05)and pulmonary hemorrhage( OR=36.846, 95% CI 5.840~232.462, P<0.05)were independently influencing factors of mortality.Apgar scores≥7 at one minute( OR=0.157, 95% CI 0.032~0.761, P<0.05)decreased the mortality. Conclusion:The majority of neonatal pneumothorax occurs within 48 h of birth and most are unilateral.The pneumothorax in preterm was mostly resulted from perinatal factors.Some factors are associated with the increasing of mortality.