Active Treatment of Infants Born at 22-25 Weeks of Gestation in California, 2011-2018.
Active Treatment of Infants Born at 22-25 Weeks of Gestation in California, 2011-2018.
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DOI：
10.1016/j.jpeds.2022.06.013
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发表时间：
2022-10
影响因子：
5.1
通讯作者：
Lee, Henry C.
中科院分区：
文献类型：
--
作者：
Chen, Xuxin;Lu, Tianyao;Gould, Jeffrey;Hintz, Susan R.;Lyell, Deirdre J.;Xu, Xiao;Sie, Lillian;Rysavy, Matthew;Davis, Alexis S.;Lee, Henry C.
确定以人群为基础的22-25周出生的婴儿积极治疗的比率和趋势，并检查与积极治疗相关的因素。这项观察性研究评估了2011年至2018年期间在加州围产期质量护理合作医院出生的妊娠22-25周的8247名婴儿。采用多变量logistic回归将产妇人口统计学和产前因素、胎儿特征和医院护理水平与积极治疗的主要结局联系起来。对6657名婴儿进行了积极治疗。22周时的发生率为19.4%，且随孕周的增加而增加，22周或23周妊娠期第4至6天出生的婴儿的发生率明显高于妊娠期第0至3天出生的婴儿（分别为26.2%和78.3%，分别为14.1%和65.9%;P < 0.001）。从2011年到2018年，23周的积极治疗率上升（从64.9%上升到83.4%;P < 0.0001），但在22周时没有显著变化。与积极治疗增加的几率相关的因素包括母亲的西班牙裔和黑人种族、早产、胎膜早破、产科出血、产前类固醇和剖宫产。与风险降低相关的因素包括胎龄低和胎龄小的出生体重。在加利福尼亚州，2011年至2018年期间，妊娠23周的积极治疗率有所增加，但22周的积极治疗率没有增加。在22周和23周时，比率在周后半部分增加。一些母亲和婴儿因素与积极治疗的可能性有关。
To determine the rate and trend of active treatment in a population-based cohort of infants born at 22–25 weeks of gestation and to examine factors associated with active treatment. This observational study evaluated 8247 infants born at 22–25 weeks of gestation at hospitals in the California Perinatal Quality Care Collaborative between 2011 and 2018. Multivariable logistic regression was used to relate maternal demographic and prenatal factors, fetal characteristics, and hospital level of care to the primary outcome of active treatment. Active treatment was provided to 6657 infants. The rate at 22 weeks was 19.4% and increased with each advancing week, and was significantly higher for infants born between days 4 and 6 at 22 or 23 weeks of gestation compared with those born between days 0 and 3 (26.2% and 78.3%, respectively, vs 14.1% and 65.9%, respectively; P < .001). The rate of active treatment at 23 weeks increased from 2011 to 2018 (from 64.9% to 83.4%; P < .0001) but did not change significantly at 22 weeks. Factors associated with increased odds of active treatment included maternal Hispanic ethnicity and Black race, preterm premature rupture of membranes, obstetrical bleeding, antenatal steroids, and cesarean delivery. Factors associated with decreased odds included lower gestational age and small for gestational age birth weight. In California, active treatment rates at 23 weeks of gestation increased between 2011 and 2018, but rates at 22 weeks did not. At 22 and 23 weeks, rates increased during the latter part of the week. Several maternal and infant factors were associated with the likelihood of active treatment.
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DOI：
10.1080/14767058.2017.1393066
发表时间：
2019-03-04
影响因子：
1.8
作者：
Edmonds, Brownsyne Tucker;Savage, Teresa A.;Kavanaugh, Karen
通讯作者：
Kavanaugh, Karen
影响因子：
2
作者：
Arzuaga, Bonnie H.;Meadow, William
通讯作者：
Meadow, William
影响因子：
2
作者：
Arbour, Kaitlyn;Lindsay, Elizabeth;Dunbar, Alston E., III
通讯作者：
Dunbar, Alston E., III
影响因子：
8
作者：
Edmonds, Brownsyne Tucker;Fager, Corinne;Lorch, Scott
通讯作者：
Lorch, Scott
影响因子：
2.8
作者：
Lynch, Courtney D.;Zhang, Jun
通讯作者：
Zhang, Jun