Clinical Study Of Spontaneous Intestinal Perforation In Preterm Infants

Objective: Explore the risk factors of spontaneous intestinal perforation(SIP)in preterm infants,and provide evidence for reducing the occurrence of SIP.Methods: Used a retrospective nested case-control study design,preterm infants admitted to the Neonatal Intensive Care Unit of Chongqing Medical University Children’s Hospital from January 2010 to June 2020 were included.Among them,SIP preterm infants were diagnosed as the SIP group.According to a ratio of about 1:2,preterm infants of the same gestational age and without intestinal perforation were randomly selected as the control group.The clinical characteristics of the two groups were compared,and the risk factors of SIP were analyzed by multivariate logistic regression.Results: A total of 21,263 preterm infants were admitted during the study period,including 28 cases in the SIP group and 61 cases in the control group.The results of univariate analysis of the two groups showed that periventricular-intraventricular hemorrhage(PIVH)of grade III and above(21.4% vs.1.4%,P=0.040),early-onset sepsis(35.7% vs.16.4%,χ2=4.112),P=0.043),septic shock(25.0%vs.4.9%,χ2=5.877,P=0.015),hypoproteinemia(85.7% vs.54.1%,χ2=8.330,P=0.004),anemia(78.6% vs.55.7%,χ2=4.289,P=0.038),dopamine exposure within 1 week(67.9% vs.23.0%,χ2=16.588,P=0.000),the difference was statistically significant.Multivariate logistic regression showed that dopamine exposure within 1 week(OR=3.874,95%CI 1.177-12.752,P=0.026)was the independent risk factors for SIP in preterm infants.Conclusion: PIVH grade III and above,early-onset sepsis,septic shock,hypoproteinemia,anemia,and dopamine exposure within 1 week may be risk factors for SIP.