Improving prognosis for infants weighing 1000 g or less at birth.
Improving prognosis for infants weighing 1000 g or less at birth.
复制标题
改善出生时体重 1000 克或以下的婴儿的预后。
DOI：
10.1136/adc.55.6.422
复制
发表时间：
1980
影响因子：
5.2
通讯作者：
E. Hollingsworth
中科院分区：
文献类型：
--
作者：
YU Yh;E. Hollingsworth
在1977年和1978年的两年中，维多利亚女王医疗中心新生儿病房收治了55名体重小于或等于1 000克的婴儿。总体新生儿存活率为60%;体重501-750 g的婴儿存活率为44%，体重751-1000 g的婴儿存活率为67%。1例新生儿死亡发生在第51天。80%的婴儿存在母亲风险因素，但对存活率没有影响。围产期窒息，如5分钟时Apgar评分小于或等于3，入院时碱缺乏大于10 mmol/l，与生存率降低相关。随着出生后年龄的增加，死亡率数据被用来制作一个图表，顺序预测新生儿存活率。脑室内出血仍然是最常见的尸检结果。随访32名幸存者至今没有显示出任何异常，除了一个晶状体后纤维组织增生，和一个原因不明的脑穿通。我们的结论是，体重小于或等于1000克的婴儿的预后继续改善。然而，从这些婴儿的临床和病理特征的审查，很明显，这一结果需要复杂的组织和昂贵的资源，在围产期中心，高风险的妊娠必须转移到出生前和出生后的最佳管理。
In the two years 1977 and 1978, 55 infants weighing less than or equal to 1000 g were admitted to the neonatal unit of the Queen Victoria Medical Centre. Overall neonatal survival was 60%; 44% of infants weighing 501-750 g and 67% of infants weighing 751-1000 g survived. One postneonatal death occurred at 51 days. Maternal risk factors were present in 80% of infants, although none had an effect on survival. Perinatal asphyxia, as indicated by an Apgar score less than or equal to 3 at five minutes, and base deficit greater than 10 mmol/l on admission, were associated with decreased survival. Mortality data with increasing postnatal age were used to produce a chart for sequential predication of neonatal survival. Intraventricular haemorrhage remained the most common necropsy finding. Follow-up of 32 survivors to date has shown no abnormalities, with the exception of one retrolental fibroplasia, and one porencephaly of unknown aetiology. We conclude that the prognosis for infants weighing less than or equal to 1000 g has continued to improve. From a review of the clinical and pathological characteristics in these infants however, it is obvious that this outcome requires complex organisation and costly resources in perinatal centres to which high-risk pregnancies must be transferred for optimal management both before and after birth.