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1.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(8): 814-820, 2021 Aug 15.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-34511171

RESUMO

OBJECTIVES: To study the survival rate and the incidence of complications of very preterm infants and the factors influencing the survival rate and the incidence of complications. METHODS: The medical data of the very preterm infants with a gestational age of <32 weeks and who were admitted to the Department of Neonatology in 11 hospitals of Jiangsu Province in China from January 2018 to December 2019 were retrospectively reviewed. Their survival rate and the incidence of serious complications were analyzed. A multivariate logistic regression analysis was used to evaluate the risk factors for death and serious complications in very preterm infants. RESULTS: A total of 2 339 very preterm infants were enrolled, among whom 2 010 (85.93%) survived and 1 507 (64.43%) survived without serious complications. The groups with a gestational age of 22-25+6 weeks, 26-26+6 weeks, 27-27+6 weeks, 28-28+6 weeks, 29-29+6 weeks, 30-30+6 weeks, and 31-31+6 weeks had a survival rate of 32.5%, 60.6%, 68.0%, 82.9%, 90.1%, 92.3%, and 94.8% respectively. The survival rate tended to increase with the gestational age (P<0.05) and the survival rate without serious complications in each gestational age group was 7.5%, 18.1%, 34.5%, 52.2%, 66.7%, 75.7%, and 81.8% respectively, suggesting that the survival rate without serious complications increased with the gestational age (P<0.05). The multivariate logistic regression analysis showed that high gestational age, high birth weight, and prenatal use of glucocorticoids were protective factors against death in very preterm infants (P<0.05), and 1-minute Apgar score ≤3 was a risk factor for death in very preterm infants (P<0.05); high gestational age and high birth weight were protective factors against serious complications in very preterm infants who survived (P<0.05), while 5-minute Apgar score ≤3 and maternal chorioamnionitis were risk factors for serious complications in very preterm infants who survived (P<0.05). CONCLUSIONS: The survival rate is closely associated with gestational age in very preterm infants. A low 1-minute Apgar score (≤3) may increase the risk of death in very preterm infants, while high gestational age, high birth weight, and prenatal use of glucocorticoids are associated with the reduced risk of death. A low 5-minute Apgar score (≤3) and maternal chorioamnionitis may increase the risk of serious complications in these infants, while high gestational age and high birth weight may reduce the risk of serious complications.


Assuntos
Doenças do Prematuro , Recém-Nascido Prematuro , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Recém-Nascido de muito Baixo Peso , Gravidez , Estudos Retrospectivos , Taxa de Sobrevida
2.
Zhongguo Dang Dai Er Ke Za Zhi ; 22(7): 690-695, 2020 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-32669162

RESUMO

OBJECTIVE: To investigate the incidence of severe neonatal hyperbilirubinemia and the management on the treatment and follow-up of this disease in Jiangsu Province, China. METHODS: The neonates with severe hyperbilirubinemia who were admitted to 13 hospitals in Jiangsu Province from January to December, 2018, were enrolled as subjects. A retrospective analysis was performed on their mediacal data and follow-up data. RESULTS: In 2018, 740 neonates with severe hyperbilirubinemia were reported from the 13 hospitals in Jiangsu Province, accounting for 2.70% (740/27 386) of the total number of neonates admitted to the department of neonatology. Among these neonates, 620 (83.8%) had severe hyperbilirubinemia, 106 (14.3%) had extremely severe hyperbilirubinemia, and 14 (1.9%) had hazardous hyperbilirubinemia. Four neonates (0.5%) were diagnosed with acute bilirubin encephalopathy. A total of 484 neonates (65.4%) were readmitted due to severe hyperbilirubinemia after discharge from the delivery institution, with a median age of 7 days, among whom 214 (44.2%) were followed up for jaundice at the outpatient service before readmission, with a median age of 6 days at the first time of outpatient examination. During hospitalization, 211 neonates (28.5%) underwent cranial MRI examinations, among whom 85 (40.3%) had high T1WI signal in the bilateral basal ganglia and the globus pallidus; 238 neonates (32.2%) underwent brainstem auditory evoked potential examinations, among whom 14 (5.9%) passed only at one side and 7 (2.9%) failed at both sides. The 17 neonates with acute bilirubin encephalopathy or hazardous hyperbilirubinemia were followed up. Except one neonate was lost to follow-up, and there were no abnormal neurological symptoms in the other neonates. CONCLUSIONS: Neonates with severe hyperbilirubinemia account for a relatively high proportion of the total number of neonates in the department of neonatology. Jaundice monitoring and management after discharge from delivery institutions need to be strengthened. For neonates with severe hyperbilirubinemia, relevant examinations should be carried out more comprehensively during hospitalization and these neonates should be followed up comprehensively and systematically after discharge.


Assuntos
Hiperbilirrubinemia Neonatal , Bilirrubina , China , Potenciais Evocados Auditivos do Tronco Encefálico , Humanos , Recém-Nascido , Estudos Retrospectivos
3.
Zhongguo Dang Dai Er Ke Za Zhi ; 20(5): 368-372, 2018 May.
Artigo em Chinês | MEDLINE | ID: mdl-29764572

RESUMO

OBJECTIVE: To investigate the incidence and mortality rates of preterm infants and the main causes of death. METHODS: The basic information of preterm infants was collected from their medical records and admission/discharge records to analyze the incidence and mortality rates of preterm infants and the causes of their death. RESULTS: There were 76 812 neonates born in the Xuzhou Maternal and Child Health Hospital from January 2006 to December 2016, among whom 5 585 (7.27%) were preterm infants. The incidence rate of preterm infants tended to increase over these years (P<0.001). The overall mortality rate was 5.01% (280/5 585), and the mortality rate tended to decrease over these years (P<0.001). The mortality rate increased with the reductions in birth weight and gestational age (P<0.001). The top four causes of death in preterm infants were respiratory distress syndrome (44.3%), severe asphyxia (12.9%), neonatal malformation (4.3%), and pulmonary hemorrhage (2.9%) respectively. With the increase in birth weight, there were significant reductions in the constituent ratios of death due to respiratory distress syndrome and severe asphyxia (P<0.001). CONCLUSIONS: The incidence rate of preterm infants tended to increase and their mortality rate tended to decrease from 2006 to 2016. The mortality rate of preterm infants is associated with gestational age and birth weight. Respiratory distress syndrome and severe asphyxia are the main causes of death in preterm infants.


Assuntos
Mortalidade Infantil , Recém-Nascido Prematuro , Peso ao Nascer , Feminino , Idade Gestacional , Humanos , Incidência , Lactente , Masculino , Fatores de Tempo
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