Mortality, morbidity, and care practices for 1750 very low birth weight infants, 2016-2021.

IF 7.5 3区医学 Q1 MEDICINE, GENERAL & INTERNAL Chinese Medical Journal Pub Date : 2024-10-20 Epub Date: 2024-02-26 DOI:10.1097/CM9.0000000000002923

Yang He, Meng Zhang, Jun Tang, Wanxiu Liu, Yong Hu, Jing Shi, Hua Wang, Tao Xiong, Li Zhang, Junjie Ying, Dezhi Mu

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Abstract

Background: Very low birth weight (VLBW) infants are the key populations in neonatology, wherein morbidity and mortality remain major challenges. The study aimed to analyze the clinical characteristics of VLBW infants.

Methods: A retrospective cohort study was conducted in West China Second Hospital between January 2016 and December 2021. Neonates with a birth weight of <1500 g were included. Mortality, care practices, and major morbidities were analyzed, and compared with those of previous 7 years (2009-2015).

Results: Of the total 1750 VLBW, 1386 were infants born with birth weight between 1000-1499 g and 364 infants were born with weight below 1000 g; 42.9% (751/1750) required delivery room resuscitation; 53.9% (943/1750) received non-invasive ventilation only; 38.2% (669/1750) received invasive ventilation; 1517 VLBW infants received complete treatment. Among them, 60.1% (912/1517) of neonates had neonatal respiratory distress syndrome (NRDS), 28.7% (436/1517) had bronchopulmonary dysplasia (BPD), 22.0% (334/1517) had apnea, 11.1% (169/1517) had culture-confirmed sepsis, 8.4% (128/1517) had pulmonary hemorrhage, 7.6% (116/1517) had severe intraventricular hemorrhage (IVH)/periventricular leukomalacia (PVL), 5.7% (87/1517) had necrotizing enterocolitis (NEC), and 2.0% (31/1517) had severe retinopathy of prematurity. The total and in-hospital mortality rates were 9.7% (169/1750) and 3.0% (45/1517), respectively. The top three diagnoses of death among those who had received complete treatment were sepsis, NRDS, and NEC. In 2009-2015, 1146 VLBW were enrolled and 895 infants received complete treatment. The proportions of apnea, IVH, and IVH stage ≥3/PVL, were higher in 2009-2015 compared with those in 2016-2021, while the proportions of NRDS and BPD were characterized by significant increases in 2016-2021. The total and in-hospital mortality rates were 16.7% (191/1146) and 5.6% (50/895) respectively in 2009-2015.

Conclusion: Among VLBW infants born in 2016-2021, the total and in-hospital mortality rates were lower than those of neonates born in 2009-2015. Incidences of NRDS and BPD increased in 2016-2021, which affected the survival rates and long-term prognosis of VLBW.

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2016-2021年，对1750名出生体重极轻婴儿的死亡率、发病率和护理方法进行的回顾性队列研究。

背景：极低出生体重儿（VLBW）是新生儿科的重点人群，其发病率和死亡率仍是主要挑战：方法：开展一项回顾性队列研究，旨在分析 2016 年 1 月至 2021 年 12 月期间我院极低出生体重儿的临床特征。新生儿出生体重为 0.5 千克：在1750例VLBW中，1386例出生体重在1000-1499克之间，364例低于1000克，42.9%（751/1750）需要产房复苏，53.9%（943/1750）仅接受无创通气，38.2%（669/1750）接受有创通气；1517例VLBW婴儿接受了完全治疗。其中，60.1%（912/1517）的新生儿患有新生儿呼吸窘迫综合征（NRDS），28.7%（436/1517）的新生儿患有支气管肺发育不良（BPD），22.0%（334/1517）的新生儿患有呼吸暂停，11.1%（169/1517）的新生儿患有经培养证实的败血症，8.4%（128/1517）有肺出血，7.6%（116/1517）有严重脑室内出血（IVH）/脑室周围白质异常（PVL），5.7%（87/1517）有坏死性小肠结肠炎（NEC），2.0%（31/1517）有严重早产儿视网膜病变。总死亡率和院内死亡率分别为 9.7%（169/1750）和 3.0%（45/1517）。在接受完全治疗的患者中，死亡诊断的前三位分别是败血症、NRDS 和 NEC。2009-2015 年，共有 1146 名低龄早产儿入组，其中 895 名婴儿接受了完全治疗。与 2016-2021 年相比，2009-2015 年呼吸暂停、IVH 和 IVH 分期≥3/PVL 的发生率较高，而 2016-2021 年 NRDS 和 BPD 的发生率显著增加。2009-2015年的总死亡率和院内死亡率分别为16.7%（191/1146）和5.6%（50/895）：结论：在2016-2021年出生的低体重儿中，总死亡率和院内死亡率均低于2009-2015年出生的新生儿。2016-2021年NRDS和BPD的发生率增加，影响了VLBW的存活率和长期预后。

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来源期刊

Chinese Medical Journal 医学-医学：内科

CiteScore

9.80

自引率

4.90%

发文量

19245

审稿时长

6 months

期刊介绍： The Chinese Medical Journal (CMJ) is published semimonthly in English by the Chinese Medical Association, and is a peer reviewed general medical journal for all doctors, researchers, and health workers regardless of their medical specialty or type of employment. Established in 1887, it is the oldest medical periodical in China and is distributed worldwide. The journal functions as a window into China’s medical sciences and reflects the advances and progress in China’s medical sciences and technology. It serves the objective of international academic exchange. The journal includes Original Articles, Editorial, Review Articles, Medical Progress, Brief Reports, Case Reports, Viewpoint, Clinical Exchange, Letter,and News,etc. CMJ is abstracted or indexed in many databases including Biological Abstracts, Chemical Abstracts, Index Medicus/Medline, Science Citation Index (SCI), Current Contents, Cancerlit, Health Plan & Administration, Embase, Social Scisearch, Aidsline, Toxline, Biocommercial Abstracts, Arts and Humanities Search, Nuclear Science Abstracts, Water Resources Abstracts, Cab Abstracts, Occupation Safety & Health, etc. In 2007, the impact factor of the journal by SCI is 0.636, and the total citation is 2315.