极早产儿产房复苏插管影响因素分析

目的 探讨极早产儿产房复苏插管影响因素以降低插管风险.方法 回顾性分析2017年1月至2019年12月入住新生儿重症监护病房的极早产儿455例,依据复苏时是否插管分为插管组(79例)和非插管组(376例),分析复苏插管的影响因素.结果 极早产儿中复苏时插管发生率为17.4％(79/455).非插管组胎龄、出生体重及剖宫...

Risk factors for endotracheal intubation during resuscitation in the delivery room among very preterm infants

Objective To explore the risk factors for endotracheal intubation during resuscitation in the delivery room among very preterm infants. Methods A retrospective analysis was performed for 455 very preterm infants who were admitted to the neonatal intensive care unit from January 2017 to December 2019. They were divided into an intubation group(n=79) and a non-intubation group(n=376) according to whether endotracheal intubation was performed during resuscitation. The risk factors for endotracheal intubation during resuscitation were evaluated by multivariate logistic regression analysis. Results The intubation rate was 17.4%(79/455). Compared with the intubation group, the non-intubation group had significantly higher gestational age, birth weight, and rates of caesarean birth, delayed cord clamping(DCC), resuscitation quality improvement, regular use of antenatal glucocorticoids in mothers and premature rupture of membranes >18 hours(P<0.05), but significantly lower rates of maternal gestational diabetes mellitus, placental abruption, placenta previa or placenta previa status, and maternal thyroid dysfunction(P<0.05). Regular use of antenatal glucocorticoids in mothers(OR=0.368, P<0.05) and DCC(OR=0.222, P<0.05) were protective factors against intubation during resuscitation, while younger gestational age, birth weight <750 g, maternal gestational diabetes mellitus, and placenta previa or placenta previa status were risk factors for intubation during resuscitation(P<0.05). Conclusions Very preterm infants with younger gestational age, birth weight <750 g, maternal diabetes mellitus, placenta previa or placenta previa status may have a higher risk for endotracheal intubation after birth. The regular use of antenatal glucocorticoids and DCC can reduce the risk of intubation during resuscitation in very preterm infants.