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对于极早分娩的护理实践的变化
Danielle LoRe1, Catherine M Groden2, Allison R Schuh3
1Department of Pediatrics, Columbia University, New York, New York.
Pediatrics
|August 12, 2024
概括
在2011-2020年期间,极早产婴儿的干预率增加,与黑人出生人种族和先前早产相关的试图复苏率 (AR) 更高. 这些高风险分娩的生存率也得到了改善.
科学领域:
- 围产科和新生儿医学
- 生殖健康结果的结果.
- 公共卫生和流行病学
背景情况:
- 极早分娩 (怀孕22-24周) 是一个高风险的产科和新生儿挑战.
- 了解影响干预的时间趋势和因素对于改善结果至关重要.
- 护理实践的中心间变化可能会影响极度早产新生儿的生存率.
研究的目的:
- 评估极早分娩 (妊娠22-24周) 的干预措施的随时间变化.
- 评估不同美国中心的护理实践的变化.
- 确定与干预相关的分娩人 (BP) 因素,特别是试图复苏 (AR).
主要方法:
- 追溯分析了2028名分娩人员和2327名怀孕22至24周之间分娩的新生儿.
- 从13个美国中心收集的数据涵盖了2011-2020年,分为两个时代.
- 评估新生儿咨询,产前皮质类固醇,剖腹产,活产,试图复苏 (AR) 和生存率,根据时代,中心和妊娠年龄进行分析.
主要成果:
- 在22周和23周怀孕期间,观察到干预和活产率的显著增加.
- 在22周,AR率从20.1%上升到36.9%,生存率从3.0%上升到8.9%.
- 多变量分析确定了黑人BP种族,以前的过早分娩和分娩中心是与试图复苏 (AR) 相关的重要因素.
结论:
- 极度早产新生儿的干预率有所增加,随着中心间变异性的变化.
- 时间趋势显示结果有所改善,但差异仍然存在.
- 产妇的种族 (黑人),过早分娩史和分娩中心是影响极早分娩的复苏工作的关键因素.
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