Very low birth weight outcomes of the National Institute of Child health and human development neonatal research network, January 1995 through December 1996. NICHD Neonatal Research Network.
Very low birth weight outcomes of the National Institute of Child health and human development neonatal research network, January 1995 through December 1996. NICHD Neonatal Research Network.
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发表时间：
2001
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影响因子：
8
通讯作者：
J. Lemons;C. Bauer;W. Oh;S. Korones;L. Papile;B. Stoll;J. Verter;M. Temprosa;L. Wright;R. Ehr
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文献类型：
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作者：
J. Lemons;C. Bauer;W. Oh;S. Korones;L. Papile;B. Stoll;J. Verter;M. Temprosa;L. Wright;R. Ehr
确定重量为401至1500 g（非常低出生体重[VLBW]）婴儿的死亡率和发病率的目的，胎龄，出生体重和性别。从1995年1月至1996年12月，在国立儿童健康与人类发展研究所的14个参与中心的新生儿研究网络中，从1995年1月至1996年12月的天生队列中前瞻性地收集了研究设计围产期数据，并将其与先前报告的相应数据进行了比较。评估了社会人口统计学因素，围产期事件和新生儿病程至120天的生命，出院或死亡。在出生时重501至1500 g的4438名婴儿中有84％的婴儿在出院或长期护理设施中幸存下来（1991年为80％，1988年为74％）。婴儿出生时的生存率为54％，出生时为54％，那些751至1000 g的生存率为86％，1001至1250 g的生存率为94％，为1251至1500G的生存率为94％，为97％。慢性肺疾病的发生率（CLD；定义为在月经后36周接受补充氧； 23％），已证明坏死性小肠结肠炎（NEC; 7％）和严重的颅内出血（ICH; ICH; III级或IV级； 11％）在1991年至1996年之间保持不变。此外，所有VLBW婴儿中的97％和99％的婴儿出生时的体重<1000 g的重量低于月经后36周的第10个百分位数。重401至500 g的195名婴儿的死亡率为89％，几乎所有幸存者都在发展CLD。体重501至600 g的婴儿的死亡率为71％；在幸存者中，有62％的人患有CLD，35％的人患有严重的ICH，而15％的人证明了NEC。出生时501至1500 g之间的婴儿的结论持续改善，特别是在出生时体重<1000 g的婴儿。由于CLD，经过证明的NEC和严重ICH的发生率没有改变，因此生存率的改善与主要病因的增加无关。然而，产后差的差仍然是一个主要问题，在出生时体重<1000 g的婴儿中，有99％发生。对于最小的婴儿，尤其是出生时体重<600 g的患者，死亡率和主要发病率（CLD，严重ICH和NEC）仍然很高。
OBJECTIVES To determine the mortality and morbidity for infants weighing 401 to 1500 g (very low birth weight [VLBW]) at birth by gestational age, birth weight, and gender. STUDY DESIGN Perinatal data were collected prospectively on an inborn cohort from January 1995 through December 1996 by 14 participating centers of the National Institute of Child Health and Human Development Neonatal Research Network and were compared with the corresponding data from previous reports. Sociodemographic factors, perinatal events, and the neonatal course to 120 days of life, discharge, or death were evaluated. RESULTS Eighty four percent of 4438 infants weighing 501 to 1500 g at birth survived until discharge to home or to a long-term care facility (compared with 80% in 1991 and 74% in 1988). Survival to discharge was 54% for infants 501 to 750 g at birth, 86% for those 751 to 1000 g, 94% for those 1001 to 1250 g, and 97% for those 1251 to 1500g. The incidence of chronic lung disease (CLD; defined as receiving supplemental oxygen at 36 weeks' postmenstrual age; 23%), proven necrotizing enterocolitis (NEC; 7%), and severe intracranial hemorrhage (ICH; grade III or IV; 11%) remained unchanged between 1991 and 1996. Furthermore, 97% of all VLBW infants and 99% of infants weighing <1000 g at birth had weights less than the 10th percentile at 36 weeks' postmenstrual age. Mortality for 195 infants weighing 401 to 500 g was 89%, with nearly all survivors developing CLD. Mortality in infants weighing 501 to 600 g was 71%; among survivors, 62% had CLD, 35% had severe ICH, and 15% had proven NEC. CONCLUSIONS Survival for infants between 501 and 1500 g at birth continued to improve, particularly for infants weighing <1000 g at birth. This improvement in survival was not associated with an increase in major morbidities, because the incidence of CLD, proven NEC, and severe ICH did not change. However, poor postnatal growth remains a major concern, occurring in 99% of infants weighing <1000 g at birth. Mortality and major morbidity (CLD, severe ICH, and NEC) remain high for the smallest infants, particularly those weighing <600 g at birth.