怀孕29周以下的早产婴儿肺出血:一个人口队列研究
Pranav R Jani1, Traci-Anne Goyen1, James Elhindi2
1Department of Neonatology, Westmead Hospital, Westmead, Australia; The Reproduction and Perinatal Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Paediatric respiratory reviews
|May 1, 2025
概括
肺出血 (PH) 发生在5.8%的非常早产婴儿中,在那些较小的妊娠年龄 (SGA) 和出生于26周之前的婴儿中更为常见. PH增加了死亡风险,但没有长期功能障碍.
科学领域:
- 新生儿科学 新生儿科学
- 儿科肺病学 儿科肺病学
- 围产儿医学 围产儿医学
背景情况:
- 肺出血 (PH) 是早产婴儿的一种严重并发症.
- 对于妊娠年龄来说小 (SGA) 和极早 (<29周妊娠) 出生的婴儿有更高的风险.
- 了解PH与SGA身份相关的发病率和结果对于改善护理至关重要.
研究的目的:
- 确定肺出血 (PH) 的发生率,临床特征和结果.
- 为了评估PH和小于妊娠年龄 (SGA) 状态在早产婴儿<29周怀孕出生之间的关联.
- 检查PH对出院前死亡率和长期功能障碍的影响.
主要方法:
- 在澳大利亚的八家三级围产医院进行了早产婴儿<29周妊娠 (2007-2019) 的回顾性队列研究.
- 从新生儿重症监护室 (NICU) 数据库中提取的数据.
- 用于分析时间趋势和结果的多变量后勤回归模型.
主要成果:
- PH的发生率为5.8% (281/4,823名婴儿).
- 在SGA婴儿 (11.1%) 与适当成长的婴儿 (5.4%) 相比,PH发病率显著更高,在出生26周以下 (10.1%) 和≥26周 (4.2%) 的婴儿中.
- PH与出院前死亡率增加 (OR:3.97) 和严重的腹腔内出血 (OR:4.2) 相关,但在2-3年校正年龄时没有功能障碍 (OR:1.13).
结论:
- 肺出血在早产婴儿中更为普遍,这些婴儿对于妊娠年龄来说很小,并且出生时极其早产 (<26周).
- PH与出院前不良的临床结果有关,包括较高的死亡率.
- 需要进一步的研究和及时的风险预测策略,以减轻PH对这些脆弱婴儿的影响.
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