| BackgroundWith the improvement of reproductive technologies,perinatology and treatment technique of newborn,the survival rate of extremely low birth weight infants(ELBWI)is greatly increased.Since each viscera development highly immature,extremely low birth weight infants have more complications,low survival ability,mortality and the higher rate of severe disability rate.The gap of the management of extremely low birth weight infants is larger at home and abroad.Objective To summarize the risk factors,complications,treatments,prognostic factors in the clinical data of extremely low birth weight infants.Methods A retrospective study was for ELBWI admitted to Henan Honliv Hospital from January 2007 to December 2014.The basic information,perinatal factors,complications,treatments were analyzed.Results(1)General information: A total of 82 ELBWI,39 were male and 43 were female;the average gestational age was(27.5±1.8)weeks and birth weight was(836.5±100.7)g;the average age of gravida was(26.7±4.6)years old;39 were multipara;60 were eutocia;46born in our hospital;37 were treated antenatal corticorsteriod therapy;42 had postpartum asphyxia.34 cases were improved,32 cases gave up treatment,16 cases were dead.Death factor was mainly to give up treatment.The leading causes of death were mainly sepsis(n=8),pulmonary hemorrhage(n=6),NEC(n=2).The survival rate of ELBWI in2007-2008,2009-2010,2011-2012,2013-2014 was 16.7%(2/12),25.0%(4/16),43.5%(10/23),58.1%(18/31),respectively.(2)The high-risk factors: Premature rupture of membranes(n=28,34.1%),multiplepregnancy(n=22,26.8%),pregnancy-induced hypertension syndrome(n=18,21.9%),tired(n=11,13.4%),test-tube baby(n=5,6.1%),abnormal umbilical cord(n=5,6.1%),placental abnormality(n=5,6.1%),amniotic fluid abnormality(n=4,4.9%),fetal distress(n=3,3.7%),chronic diseases(n=3,3.7%),unknown causes(n=10,12.2%).(3)Complications of survivors: Neonatal respiratory syndrome(NRDS)(n=32,94.1%),apnea(n=34,100%),sepsis(n=34,100%),jaundice(n=34,100%),anemia(n=34,100%),feeding difficulty(n=34,100%),bronchopulmonary dysplasia(BPD)(n=24,70.6%),retinopathy of prematurity(ROP)(n=22,64.7%),patent ductus arteriosus(PDA)(n=20,58.8%),clolestasis(n=20,58.8%),braininjury(n=12,35.3%),shock(n=4,11.8%),neonatal necrotizing enterocolitis(NEC)(n=1,2.9%).(4)Treatments of survivors: 17 received tracheal intubation,17 received PS,15 received INSURE,17 received ibuprofen,32 received early minimal feeding,28 received breast feeding,25 received blood transfusion,34 received NCPAP and the average time was 18.2 d,34 received oxygen and the average time was 9.7 d,12 received invasive mechanical ventilation and the average time was 6.3 d,no high concentration oxygen,5 of the BPD used hormone,antibiotic application time accounted for 47% of hospital stay.28 received PICC and the average time was 36 d.(5)Result of the factors influencing the prognosis: There was significant difference in survival rate between different weight group(P<0.05);There were significant difference in survival rate and in rate of giving up between different gestational age(P<0.05).The difference between survival and death have statistical significance(P<0.05)in gestational age,birth weight,born in our hospital,antenatal corticorsteriod therapy and postpartum asphyxia.Gestational age and antenatal corticorsteriod therapy have significantly negative effects on death(gestational age: b=-0.214,P<0.05;antenatal corticorsteriod therapy: b =-0.737,P<0.05).Postpartum asphyxia have significantly positive effects on death(postpartum asphyxia: b =0.980,P<0.05).ConclusionsThe number and the survival rate of ELBWI had increased dramatically each year.ELBWI have many complications,which need complex treatment.Preterm birth mainly associated with premature rupture of membranes.Avoid small gestational age,postpartum asphyxia and use antenatal corticorsteriod therapy might improve the outcome of ELBWI. |
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