极低出生体质量和极早早产与新生儿生存状况的关系

目的 探讨极低出生体质量和极早早产与新生儿的生存状况及相关影响因素.方法 选取2012年4月至2016年1月该院收治的极低出生体质量儿(VLBWI)和极早早产儿(VPI) 142例,选取同期出生的非VLBWI和非VPI 140例,比较入组新生儿的生存状况及远期预后,根据生存状况将VLBWI与VPI分为死亡组和存活组,对两组患儿的临床资料进行单因素和多因素Logistic回归分析.结果 出生体质量小于1 500、1 500～2 500、＞2 500 g新生儿的预后不良发生率比较,差异有统计学意义(P＜0.05).胎龄小于32周、32～37周、≥37周新生儿的预后不良发生率比较,差异有统计学意义(P＜0.05).死亡组新生儿的胎龄、出生体质量和产前使用地塞米松的比例明显低于存活组,母亲年龄、窒息、胎粪吸入、妊娠高血压综合征和机械通气比例明显高于存活组,两组比较差异有统计学意义(P＜0.05).≤28周胎龄、≤1 000 g出生体质量、窒息是影响VLBWI与VPI生存状况的独立危险因素(P＜0.05).结论 VLBWI与VPI的生存状况及远期预后不佳,易发生智力和运动障碍.

Relationship between very low birth weight and very early premature delivery with neonatal survival status

Objective To investigate the survival status and related influencing factors of very low birth weight infants(VL-BWI) and very early preterm infants(VPI).Methods One hundred and forty-two very low birth weight and very preterm infants in our hospital from April 2012 to January 2016 and contemporaneous 140 non-low-birth-weight and non-very-preterm infants were selected.The survival status of newborns and long-term prognosis were compared.The low birth weight children and very preterm infants were divided into the death group and survival group according to the survival status and long-term prognosis.The clinical data in the two groups were performed the univariate and multivariate Logistic regression analysis.Results The incidence rate of poor prognosis had statistically significant difference among neonates with birth weight less than 1 500,1 500-2 500 and＞2 500 g(P＜0.05).The incidence rate of poor prognosis had statistically significant difference among neonates with the gestational age≤32 weeks,32-37 weeks and≥37 weeks(P＜0.05).The proportions of gestational age,birth weight and antenatal dexamethasone use in the death group were significantly lower than those in the survival group,while the proportions of maternal age,asphyxia,meconium aspiration,pregnancy induced hypertension and mechanical ventilation in the death group were significantly higher than those in the survival group,the difference between two groups was statistically significant(P＜0.05).The gestational age≤28 weeks,birth weight≤1 000 g and asphyxia were the independent risk factors affecting the survival status in very low birth weight infants and extremely preterm infants(P＜0.05).Conclusion In VLBWI and VPI the living status,and long-term prognosis are poor and prone to mental and movement disorders.