Analysis Of Clinical And Death Related Factors In 307 Very Premature Infants And Very Low Birth Weight Infants

Objective:The clinical data of very premature infants(VP)and very low birth weight infants(VLBW)O in our hospital were collected by retrospective study,and their clinical characteristics,outcomes and death related factors were analyzed.To provide a clinical basis for improving the management level of very premature infants in our hospital and improving their survival rate.Methods:307 cases of VP and VLBW who were born in the Department of Obstetrics and Gynecology of the First Affiliated Hospital of Kunming Medical University from January 1,2015 to December 31,2017,were enrolled.The general condition and perinatal data were collected.Clinical data such as disease diagnosis and prognosis.Data were analyzed using spss24.0 statistical software,p<0.05 was statistically significant.Results:1.The overall survival rate of 307 cases of VP and VLBW was 82.4%,and the mortality rate was 17.6%.He was cured,improved,transferred,abandoned,and died at the time of discharge,accounting for 46.6%,30.9%,2%,13.3%,and 7.1%,respectively.The gestational age is<27 weeks,27-27+6 weeks,28-28+6 weeks,29-29+6 weeks,30-30+6 weeks,31-31+6 weeks,32-The survival rates of 33+6 weeks and ≥34 weeks were 25%,53.3%,66.7%,81.8%,79.2%,94.5%,89.6%,and 93.1%,respectively.The survival rates of birth weights<1000g,1000-1249g,1250-1499g,and≥1500g were 46.2%,74.7%,87.5%,and 95.5%,respectively.2.The main cause of preterm birth is hypertensive disorder of pregnancy(26.7%),followed by PPROM(25.1%),clinical chorioamnionitis(12.7%),twin/multiple(10.4%),intrauterine distress(7.2%),placenta preposition/early stripping(8.1%).3.The common complications of VP and VLBW in this study were:neonatal hyperbilirubinemia(74.3%),neonatal sepsis(41.4%),neonatal anemia(39.4%),PVH-IVH(35.5%).),BPD(33.2%),neonatal pneumonia(31.3%),NRDS(27.4%),EUGR(26.1),neonatal feeding intolerance(20.5%),neonatal hypoglycemia(19.2%),low neonatal Calcemia(17.3%),neonatal asphyxia(8.5%),NEC(6.5%),PDA(6.2%),etc.4.The main cause of death of VP and VLBW was infection(68.2%),followed by NRDS(13.6%)、Hereditary metabolic diseases(3.7%).The deaths of VP and VLB W were mainly in the first week of birth.The cumulative mortality rates within 24 hours,3 days,1 week and 4 weeks were 13.0%,27.8%,46.3%and 85.2%respectively.5.Analysis of risk factors for children’s outcome:gestational age,body weight,placental abruption/preposition,neonatal hyperbilirubinemia,neonatal sepsis,BPD,EUGR,NRDS,feeding intolerance,neonatal hypocalcemia Disease,neonatal asphyxia,tracheal intubation in the delivery room,use of PS,etc.Statistically significant,binary multivariate logistic regression results suggest that low birth weight,neonatal sepsis,NRDS,and placental abruption/preposition,are independent risk factors for death.Conclusions:1.The overall survival rate ofVP andVLBW in our hospital was 82.4%,and the mortality rate was 17.6%.The gestational age at birth is<27 weeks,27-27+6 weeks,28-28+6 weeks,29-29+6 weeks,30-30+6 weeks,31-31+6 weeks,32 The survival rates of-33+6 weeks and≥34 weeks were 25%,53.3%,66.7%,81.8%,79.2%,94.5%,89.6%,and 93.1%,respectively.The survival rates of birth weights<1000g,1000-1249g,1250-1499g,and≥1500g were 46.2%,74.7%,87.5%,and 95.5%,respectively.2.The main cause of death of VP and VLBW is infection,late-onset bacterial sepsis was the main infection(49%).Strengthening nosocomial infection management and controlling and preventing nosocomial infection could reduce the mortality of VP and VLBW.3.Low birth weight,neonatal sepsis,NRDS,and placental abruption/preposition,are independent risk factors for death.