低出生体重儿死亡率与脑性瘫痪患病率的研究

目的 评估低出生体重儿新生儿期死亡和脑瘫患病风险。方法 利用安徽省两个城市1995～1999年围生儿登记资料和围生期死亡监测记录，结合脑瘫的现患调查，分析低出生体重儿新生儿期死亡情况以及脑瘫患病率。结果 低出生体重儿脑瘫占所有脑瘫病例的28．9％。在低出生体重儿中，随出生体重的下降，早期新生儿死亡率和新生儿死亡率上升；出生体重为2000～2499g、l500～l999g以及l500g以下的活产儿脑瘫患病率分别为9．29‰、18．87‰和30．30‰，与出生体重3500～3999g新生儿相比，3组低出生体重儿脑瘫患病的OR值分别为13．9、28．5和46．3。结论 低出生体重儿存活率低于发达国家，但脑瘫患病率与发达国家接近。随着极低出生体重儿存活率的上升，儿童脑瘫患病率可能会上升。

A retrospective analysis of neonatal mortality of low birthweight neonates and the prevalence of cerebral palsy at age of 1 to 6

Objective To determine the risk of neonatal m or tality and cerebral palsy prevalence of low birthweight neonates at ages of 1 to 6 years. Methods Using the perinatal register, record of neona tal death, and data collected in a cross-sectional study on cerebral palsy at age of 1 to 6 years in two cities of Anhui province, early neonatal mortality ( during 7 days of life ), neonatal mortality (during 28 days of life ) and preval ence of cerebral palsy at age of 1 to 6 years of low birthweight neonates were c alculated. Results Low birthweight infants comprised 28 9% of all ca ses of cerebral palsy. Early neonatal mortality and neonatal mortality increased with the decrease in birthweight of low birthweight infants. The prevalence ra tes of cerebral palsy among infants whose birthweight was 2 000 to 2 499 grams, 1 500 to 1 999 grams, and blow 1 500 grams were 9 29, 18 87, and 30 30 per 1 000 live born neonates, respectively. Compared with infants whose birthweight was 3 500 to 3 999 grams, the odds ratio (OR) of neonates in the three gro ups were 13 9, 28 5 and 46 3, respectively. Conclusion Neonata l livability of low birthweight infants was lower than that in developed countri es, but the prevalence of cerebral palsy was the same as that in the developed c ountries. The prevalence of cerebral palsy of children should not decrease signi ficantly in the future in China with increase of neonatal livability of very low birthweight infants.