Analysis Of High Risk Factors, Complications And Clinical Outcomes In 899 Hospitalized Preterm Infants

Objective:This article retrospectively studies the clinical data of preterm infants in the Neonatal intensive care unit(NICU)from 2016 to 2017 and explores the high risk factors of preterm birth,common complications of premature infants and causes of death,with the aim of reducing the incidence of preterm birth and complications of premature infants.In order to improve the clinical outcome of premature infants,improve the quality of life of premature infants,reduce the family burden and social burden of children.Method:Designed the registration form for the NICU Premature Infant Children’s Hospital of Suzhou University,and collected the clinical data of the premature infants in the NICU ward from January 1,2016 to December 31,2017,and analyzed the high risk factors of preterm birth.Common complications and causes of death in preterm infants.Use SPSS 19.0 software to process the data.P<0.05 was statistically significantResult:From January 2016 to December 2017,899 cases of preterm infants were admitted to the NICU ward.Details are as follows:1.In this group,30 cases(3.34%)of gestational age<28 weeks;275 cases(30.59%)of 28～31+6 weeks;233 cases(25.91%)of 32～33+6 weeks;361 cases(40.16%).of 34～36+6 weeks.2.In this group,25 cases(2.78%)were born with a birth weight of<1000g,and 202 cases(22.47%)were 1000g-1500g.Between 1500g and 2500g,492 cases(54.73%),>2500g,180 cases(20.02%)3.In this data,120 cases(13.35%)were smaller than gestational age,772 cases(85.87%)were suitable for gestational age,and 7 cases(0.78%)were larger than gestational age.4.The data showed that the risk factors of very early preterm birth were multiple pregnancy(36.67%,OR=2.036),older mothers(26.67%,OR=2.451),amniotic fluid abnormalities(23.33%,OR=1.522),test tube infants(16.67%,OR=3.489).The risk factors of early preterm birth included premature rupture of membranes(29.45%,OR=1.033),multiple pregnancy(24.00%,OR=1.381),amniotic fluid abnormality(20%,OR=1,137),eclampsia(13.45%,OR=1.072),placental abnormality(13.09%,OR=1.013),threatened preterm birth(11.64%,OR=2.189),pregnancy hypertension(7.64%,OR=1.094).The risk factors of mid-term preterm birth included premature rupture of membranes(33.91%,OR=1.674),multiple pregnancy(24.03%,OR=1.491),eclampsia(18.88%,OR=1.942),placental abnormalities(14.16%,OR=1.503),intrauterine distress(10.30%,OR=1.576),pregnancy hypertension(9.44%,OR=1.352).The risk factors of late preterm birth were:older pregnant women(15.24%,OR=1.006),gestational diabetes mellitus(13.85%,OR=1.273),intrauterine distress(11.63%,OR=1.988).By comparing the incidence of high risk factors among the four groups of premature infants,it was found that IVF,multiple pregnancies,threatened premature delivery,eclampsia,umbilical cord abnormalities,and intrauterine distress were statistically significant among the groups(P<0.05).5.Risk factors for premature birth less than gestational age are:eclampsia(43.33%,OR=7.190),amniotic fluid abnormality(30.33%,OR=3.423),older maternal(23.33%,OR=1.461),multiple pregnancy(23.33)%,OR=2.011),developmental delay(19.17%,OR=12.005),Hypertension during pregnancy(18.33%,OR=2.085),intrauterine distress(16.67%,OR=1.375).6.The main complications of very early preterm infants and early preterm infants were asphyxia,neonatal respiratory distress syndrome,bronchopulmonary dysplasia,neonatal necrotizing enterocolitis,hypoglycemia,congenital malformation and retinopathy of premature infants retinopathy of prematurity,neonatal anemia,infectious diseases(OR values were greater than 1).The incidence of complications of asphyxia,congenital malformation,BDP,NEC,ROP and NRDS in very early preterm birth was higher than that in early preterm birth.The incidence of asphyxia,hypoglycemia,congenital malformation,neonatal anemia,infectious diseases,BPD,NEC and ROP were negatively correlated with mid-term preterm birth and late preterm birth.There were significant differences in the incidence of asphyxia,apnea,pulmonary hemorrhage,intracranial hemorrhage,neonatal anemia,cholestasis,jaundice,BDP,NEC,ROP,NRDS and pneumothorax among premature infants of different gestational ages(all P<0.001).With the increase of gestational age,the incidence of asphyxia,apnea,neonatal anemia,NRDS,BDP,NEC and ROP decreased gradually.The incidence of infectious diseases was the highest in all groups of gestational age.7.The main complications of preterm infants less than gestational age were neonatal anemia(50.00%,OR=1.958),hypoglycemia(33.33%,OR=3.937),congenital malformation(31.67%,OR=1.605),ROP(8.33%,OR=1.541),NEC(6.67%,OR=1.127).8.The top five abnormal factors in the perinatal period of 73 cases of premature infants were as follows:There were 24 cases of multiple pregnancy,accounting for 32.88%;23 cases of amniotic fluid abnormality,accounting for 31.51%;15 cases of premature rupture of membranes,accounting for 20.55%;11 cases of old women,accounting for 15.07%;8 cases of abnormal umbilical cord,accounting for 10.96%.The top 5 causes of premature death were infectious diseases(27.39%),NRDS(23.29%),asphyxia(17.81%),NEC(17.81%),and malformation(4.11%).Gestational age,weight,digestive diseases,and neurological diseases are risk factors for clinical outcomes(death)in preterm infants.Conclusion:Comorbid complications and complications of preterm birth are the main causes of death in newborns.The smaller the gestational age of premature infants,the more severe the complications and complications.Early intervention is expected to reduce the morbidity and mortality of complications in preterm infants.