Neonatal Intensive Care Quality Level-Dependent Variations in the Survival Rate of Infants with a Birth Weight of 500 g or Less in Korea: A Nationwide Cohort Study.

IF 2.6 3区医学 Q1 PEDIATRICS Neonatology Pub Date : 2023-01-01 DOI:10.1159/000527613

Misun Yang, Yun Sil Chang, So Yoon Ahn, Se In Sung, Won Soon Park

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Abstract

Objective: Recent evidence suggests that the survival of peri-viable infants with birth weight (BW) ≤500 g could be improved with better care practices in the neonatal intensive care unit (NICU). This study aimed to investigate the care quality level of NICU-dependent variations in the survival rate of infants with BW ≤500 g.

Methods: To determine the quality of NICU care-dependent variations in the survival rate, 226 eligible infants of BW ≤500 g and ≥22 weeks gestation registered in the Korean Neonatal Network between 2013 and 2017 were grouped according to the survival rates of infants at 23-24 weeks gestation, reflecting the care quality level of each NICU as group I (≥50%, n = 107) and group II (<50%, n = 119).

Results: The survival rate of group I infants (40.2%, 43/107) was significantly higher than that of group II infants (14.3%, 17/119). Significantly reduced deaths from birth to the age of 7 days due to cardiorespiratory causes were the primary contributors to improved survival. In multivariable Cox hazard model analyses, besides the gestational age and BW, antenatal steroid use, cesarean section, pH, and base excess at admission were associated with improved infant survival.

Conclusions: The survival rate of pre-viable infants with BW ≤500 g could be improved by providing better NICU quality care practices, including better cardiorespiratory management starting from delivery room resuscitation.

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韩国新生儿重症监护质量水平对出生体重小于等于500g婴儿存活率的影响:一项全国性队列研究

目的:最近的证据表明，新生儿重症监护病房(NICU)更好的护理措施可以提高出生体重(BW)≤500 g的围存活期婴儿的生存率。本研究旨在探讨新生儿体重≤500 g新生儿重症监护病房(nicu)依赖性护理质量水平对新生儿存活率的影响。方法:为确定NICU护理依赖质量对存活率的影响，将2013 - 2017年在韩国新生儿网络注册的226例符合条件的BW≤500 g且妊娠≥22周的新生儿根据妊娠23-24周的婴儿存活率进行分组，将每个NICU的护理质量水平反映为I组(≥50%，n = 107)和II组(结果:I组患儿的生存率(40.2%，43/107)显著高于II组患儿(14.3%，17/119)。从出生到出生7天因心肺原因死亡的显著减少是提高生存率的主要因素。在多变量Cox风险模型分析中，除了胎龄和体重外，产前类固醇使用、剖宫产、pH和入院时碱过量也与婴儿存活率的提高有关。结论:改善新生儿重症监护病房的护理质量，包括从产房复苏开始改善心肺管理，可提高新生儿体重≤500 g的存活率。

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来源期刊

Neonatology 医学-小儿科

CiteScore

0.60

自引率

4.00%

发文量

审稿时长

6-12 weeks

期刊介绍： This highly respected and frequently cited journal is a prime source of information in the area of fetal and neonatal research. Original papers present research on all aspects of neonatology, fetal medicine and developmental biology. These papers encompass both basic science and clinical research including randomized trials, observational studies and epidemiology. Basic science research covers molecular biology, molecular genetics, physiology, biochemistry and pharmacology in fetal and neonatal life. In addition to the classic features the journal accepts papers for the sections Research Briefings and Sources of Neonatal Medicine (historical pieces). Papers reporting results of animal studies should be based upon hypotheses that relate to developmental processes or disorders in the human fetus or neonate.

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