早期发病的新生儿败血症作为早产婴儿周室内出血的危险因素
Mariana Martins Denicol1, Vanessa Bielefeldt Leotti1, Cátia Rejane Soares de Soares2
1Universidade Federal do Rio Grande do Sul, Postgraduate Program in Epidemiology - Porto Alegre (RS), Brazil.
概括
早期发作的败血症显著增加了早产婴儿周室内出血的风险. 这一发现凸显了新生儿重症监护病房迅速诊断和治疗败血症的迫切需要.
科学领域:
- 新生儿科学 新生儿科学
- 儿童传染病 儿童传染病
- 围产儿医学 围产儿医学
背景情况:
- 在怀孕34周或更短时间出生的早产婴儿面临严重并发症的高风险.
- 周室内出血 (PIVH) 是这种脆弱人群中常见且严重的疾病.
- 早期发作的败血症 (EOS) 作为PIVH的促成因素的作用需要进一步调查.
研究的目的:
- 评估早期发作的败血症作为周室内出血的危险因素.
- 为了评估EOS和PIVH之间的关联,在早产婴儿进入NICU.
主要方法:
- 对487名早产婴儿 (妊娠≤34周) 的回顾性队列研究,这些婴儿被录入巴西第三级医院NICU (2017年1月 - 2021年7月).
- 从医疗记录中收集的数据,定义生命72小时内EOS和PIVH存在,无论等级如何.
- 考克斯回归模型被用来计算危险比率.
主要成果:
- 共有169名 (34.7%) 婴儿经历了PIVH.
- 早期发作的败血症在41.6%的PIVH婴儿中被诊断出,这表明存在显著的关联.
- 多变量模型显示EOS的危险比为1.52 (95% CI 1.01-2.27),这意味着PIVH的风险增加.
结论:
- 早期发作的败血症是早产婴儿 (妊娠≤34周) 中周室内出血的重要危险因素.
- 表面活性剂的使用也与PIVH的发生增加有关.
- 产前皮质类固醇和更高的妊娠年龄 (接近34周) 是对PIVH的保护因素.
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