在极度早产婴儿中早期死亡的风险和原因 对于妊娠年龄来说出生小的婴儿
Olasunkanmi Kehinde1, Dmitry Tumin2,3, Uduak S Akpan3
1Department of Health and Human Studies, Elizabeth City State University, Elizabeth City, North Carolina.
American journal of perinatology
|February 5, 2025
概括
极度早产 (EPT) 婴儿出生小的妊娠年龄 (SGA) 面临显著更高的死亡风险. 这些风险主要与他们短暂的怀孕和低出生体重的并发症有关,这强调了改善新生儿护理的关键领域.
科学领域:
- 新生儿医学 新生儿医学
- 围产期流行病学 围产期流行病学
- 公共卫生统计 公共卫生统计
背景情况:
- 极度早产 (EPT) 分娩 (怀孕28周之前) 与患病和死亡的高风险有关.
- 对于妊娠年龄来说小的婴儿 (SGA),占EPT新生儿的8-20%,面临复合风险.
- 现有的文献提出了关于EPT SGA婴儿特定发病率和死亡原因的混合发现.
研究的目的:
- 为了确定EPT SGA婴儿的死亡率.
- 为了确定这个弱势群体中死亡的常见原因.
- 量化与EPT新生儿SGA状态相关的死亡风险增加.
主要方法:
- 使用了CDC国家生命统计系统数据 (2016-2021年出生,2022年随访).
- 包括在怀孕22-27周之间出生的婴儿入院于NICU.
- 分析了30天内全因住院死亡率,使用ICD-10代码对病因进行分类,以SGA为主要独立变量.
主要成果:
- 一个由96,134名婴儿组成的样本显示,13%的婴儿是SGA出生.
- 在SGA与非SGA婴儿之间,30天死亡率明显高 (31%对13%).
- 多变量分析显示,SGA婴儿的30天死亡率是3.82倍 (OR:3.82;95%CI:3.64,4.01) 并且更有可能死于短妊娠并发症 (RRR:1.42;95%CI:1.27,1.59).
结论:
- 需要重症监护的SGA婴儿具有高死亡风险.
- 妊娠期短和出生体重低的并发症是SGA EPT婴儿死亡的主要驱动因素.
- 这凸显了SGA地位对极度早产新生儿死亡结果的关键影响.
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