Trends in neonatal morbidity and mortality for very low birthweight infants.
Trends in neonatal morbidity and mortality for very low birthweight infants.
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DOI：
10.1016/j.ajog.2006.09.014
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发表时间：
2007-02-01
影响因子：
9.8
通讯作者：
Poole, W Kenneth
中科院分区：
文献类型：
--
作者：
Fanaroff, Avroy A;Stoll, Barbara J;Poole, W Kenneth
目的：根据胎龄、出生体重和性别，记录出生时体重 501-1500 g 的婴儿的死亡率和发病率。 研究设计：前瞻性收集 1990 年 1 月至 2002 年 12 月期间出生于国家儿童健康与人类发展新生儿研究所 16 个参与中心的婴儿的围产期事件和新生儿到 120 天生命、出院或死亡的过程。网络结果：与1995-1996年相比，1997-2002年出生体重501-1500g婴儿的存活率增加了1个百分点（从84%增加到85%）。无重大新生儿发病率的存活率保持稳定，为 70%；这包括支气管肺发育不良（BPD）、脑室内出血（IVH）和坏死性小肠结肠炎（NEC）。多胞胎（从 22% 上升到 26%）、产前皮质类固醇使用（从 71% 上升到 79%）和母体抗生素（从 62% 上升到 70%）的生存率有所提高 (P < .05)。从1997年到2002年，体重501-750克的婴儿的特定出生体重存活率为55%，751-1000克的婴儿为88%，1001-1250克的婴儿为94%，1251-1500克的婴儿为96%。更多的女性幸存下来。 NEC（7%）、严重IVH（12%）和迟发性败血症（22%）的发生率基本保持不变，但BPD略有下降，从23%降至22%。产后皮质类固醇的使用率从1997-2000年的20%下降到2001-2002年的12%。生长障碍（体重
OBJECTIVE: To document the mortality and morbidity of infants weighing 501-1500 g at birth according to gestational age, birthweight, and sex.STUDY DESIGN: Prospective collection of perinatal events and neonatal course to 120 days of life, discharge, or death from January 1990 through December 2002 for infants born at 16 participating centers of the National Institute of Child Health & Human Development Neonatal Research Network.RESULTS: Compared with 1995-1996, for 1997-2002 the survival of infants with birthweight of 501-1500 g increased by 1 percentage point (from 84% to 85%). Survival without major neonatal morbidity remained static, at 70%; this includes bronchopulmonary dysplasia (BPD), intraventricular hemorrhage (IVH), and necrotizing enterocolitis (NEC). Survival increased for multiple births (26%, up from 22%), antenatal corticosteroid use (79%, up from 71%), and maternal antibiotics (70%, up from 62%) (P < .05). From 1997 to 2002, birthweight-specific survival was 55% for infants weighing 501-750 g, 88% for 751-1000 g, 94% for 1001-1250 g, and 96% for 1251-1500 g. More females survived. The incidence of NEC (7%), severe IVH (12%), and late-onset septicemia (22%) remained essentially unchanged, but BPD decreased slightly, from 23% to 22%. The use of postnatal corticosteroids declined from 20% in 1997-2000 to 12% in 2001-2002. Growth failure (weight