Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network.
Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network.
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DOI：
10.1542/peds.2009-2959
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发表时间：
2010-09
期刊：
影响因子：
8
通讯作者：
Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
中科院分区：
文献类型：
--
作者：
Stoll BJ;Hansen NI;Bell EF;Shankaran S;Laptook AR;Walsh MC;Hale EC;Newman NS;Schibler K;Carlo WA;Kennedy KA;Poindexter BB;Finer NN;Ehrenkranz RA;Duara S;Sánchez PJ;O'Shea TM;Goldberg RN;Van Meurs KP;Faix RG;Phelps DL;Frantz ID 3rd;Watterberg KL;Saha S;Das A;Higgins RD;Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network
本报告提供了尤尼斯·肯尼迪·施赖弗国家儿童健康和人类发展研究所新生儿研究网络的数据，涉及按胎龄 (GA) 划分的极低出生体重婴儿的护理、发病率和死亡率。收集了 2003 年 1 月 1 日至 2007 年 12 月 31 日期间在网络中心出生的 9575 名极低 GA（22-28 周）和极低出生体重（401-1500 g）婴儿的围产期/新生儿数据。出院存活率随着 GA 的增加而增加（22 周时为 6%，28 周时为 92%）； 1060 名婴儿在 ≤ 12 小时内死亡，其中大多数早期死亡发生在 22 周和 23 周（分别为 85% 和 43%）。产前类固醇使用率（分别为 13% 和 53%）、剖腹产率（分别为 7% 和 24%）和产房插管率（分别为 19% 和 68%）在 22 周至 23 周期间显着增加。 GA 最低的婴儿发病的风险最大。总体而言，93% 患有呼吸窘迫综合征，46% 患有动脉导管未闭，16% 患有严重脑室内出血，11% 患有坏死性小肠结肠炎，36% 患有迟发性败血症。与传统的 36 周补充氧气使用定义相比，基于严重程度的支气管肺发育不良的新定义将更多婴儿归类为支气管肺发育不良（68% 和 42%）。超过一半的 GA 极低的婴儿在出院时视网膜病变状态尚未确定。确定了管理和结果方面的中心差异。尽管大多数 GA ≥ 24 周的婴儿都能存活，但幸存者中的高发病率仍然存在。
This report presents data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network on care of and morbidity and mortality rates for very low birth weight infants, according to gestational age (GA). Perinatal/neonatal data were collected for 9575 infants of extremely low GA (22–28 weeks) and very low birth weight (401–1500 g) who were born at network centers between January 1, 2003, and December 31, 2007. Rates of survival to discharge increased with increasing GA (6% at 22 weeks and 92% at 28 weeks); 1060 infants died at ≤ 12 hours, with most early deaths occurring at 22 and 23 weeks (85% and 43%, respectively). Rates of prenatal steroid use (13% and 53%, respectively), cesarean section (7% and 24%, respectively), and delivery room intubation (19% and 68%, respectively) increased markedly between 22 and 23 weeks. Infants at the lowest GAs were at greatest risk for morbidities. Overall, 93% had respiratory distress syndrome, 46% patent ductus arteriosus, 16% severe intraventricular hemorrhage, 11% necrotizing enterocolitis, and 36% late-onset sepsis. The new severity-based definition of bronchopulmonary dysplasia classified more infants as having bronchopulmonary dysplasia than did the traditional definition of supplemental oxygen use at 36 weeks (68%, compared with 42%). More than one-half of infants with extremely low GAs had undetermined retinopathy status at the time of discharge. Center differences in management and outcomes were identified. Although the majority of infants with GAs of ≥24 weeks survive, high rates of morbidity among survivors continue to be observed.
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