美国新生儿重症监护室婴儿的死亡风险 根据出生大小分类 对比三个生长曲线的分类
A Nicole Ferguson1, Marion Granger1, Irene E Olsen2
1School of Data Science and Analytics, Kennesaw State University, Kennesaw, Georgia, USA.
Neonatology
|April 15, 2024
概括
不同的婴儿生长曲线不同地影响了对妊娠年龄小 (SGA) 和对妊娠年龄大 (LGA) 的分类. 然而,仅仅出生大小就对早产婴儿新生儿重症监护室 (NICU) 死亡风险的预测能力较低.
科学领域:
- 新生儿科学 新生儿科学
- 围产儿医学 围产儿医学
- 生物统计学 生物统计学
背景情况:
- 标准化的生长曲线对于对婴儿人体测量进行分类至关重要 (对于妊娠年龄来说小,适当或大).
- 现有的生长曲线 (奥尔森,芬顿,INTERGROWTH-21st) 对相同的婴儿测量产生不同的分类.
- 这些分类差异对预测早产婴儿新生儿重症监护室 (NICU) 死亡风险的影响尚未完全理解.
研究的目的:
- 评估使用不同生长曲线的出生人体测量分类的变化如何影响NICU死亡风险的识别和预测.
- 为了比较各种生长曲线与早产婴儿NICU死亡率的预测性表现.
主要方法:
- 分析了46,724个单独的早产婴儿 (妊娠期24-32周) 的出生数据,这些婴儿在2013-2018年期间被录取到NICU.
- 婴儿出生体重,长度和头周的分类为小 (SGA),适当 (AGA) 或大 (LGA) 对于妊娠年龄使用奥尔森,芬顿和INTERGROWTH-21st曲线.
- 后勤回归模型被用来分析基于出生大小分类的NICU死亡风险,按妊娠年龄分层.
主要成果:
- 与适合怀孕年龄 (AGA) 婴儿相比,在所有怀孕年龄和曲线组中,SGA分类始终与增加的死亡风险有关.
- 按妊娠年龄大 (LGA) 的分类显示出与死亡风险的不同关联,在妊娠24周时具有保护性,但在妊娠30周时风险增加.
- 不同的生长曲线组之间没有观察到死亡率预测的显著差异,仅仅出生时的尺寸分类表明预测能力较低 (AUC接近0.5).
结论:
- 在预测早产婴儿NICU死亡风险方面,奥尔森,芬顿和INTERGROWTH-21st生长曲线集之间没有显著差异.
- 仅仅对出生大小的分类是识别高风险NICU死亡率的早产婴儿的不准确方法.
- 可能需要进一步的研究来确定更强大的早产婴儿死亡率预测因素.
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