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相關文獻
- Influence of Perinatal Factors on Limit of Viability in Extremely Low Birth Weight Infants
- Chronic Lung Disease in Extremely Low Birth Weight Infants: A Two-year Retrospective Analysis
- Glucose-Insulin Infusion for the Early Treatment of Non-oliguric Hyperkalemia in Extremely-Low-Birth-Weight Infants
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題名 | Influence of Perinatal Factors on Limit of Viability in Extremely Low Birth Weight Infants=影響超低出生體重兒存活界限之週產期因素 |
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作者 | 蘇百弘; 林鴻志; 彭慶添; 蔡長海; | 書刊名 | 中華民國小兒科醫學會雜誌 |
卷期 | 40:2 民88.03-04 |
頁次 | 頁87-91+137 |
分類號 | 417.5 |
關鍵詞 | 超低出生體重兒; 存活界限; 週產期因素; Extremely low birth weight infant; Perinatal factors; Limit of viability; |
語文 | 英文(English) |
中文摘要 | 本研究以在1997年1月至1998年5月間,住進中國醫藥學院附設醫院新生兒加護病房, 出生體重小於1000公克之超低出生體重兒為回溯分析之對象。有先天性異常及死產之病例不列入研 究。以存活出院為最終結果。總共收集84個新生兒。平均懷孕週數為25.8�b1.8週,平均出生體重 為772�b114公克。存活率為48.8%。最小健全存活例為懷孕23週,出生體重530公克之女嬰。對新 生兒死亡有意義影響的分界點為:懷孕週數小於24週,(odds ratio, 6.11,信賴區間,2.01~18.63), 出生體重小於700公克 (odds ratio, 2.65,信賴區間,1.09~6.39)。兩個最有意義且分別獨立影響新生 兒存活的因素為:懷孕週數小於24週 (odds ratio, 9.24,信賴區間,2.53~33.76) 及生後早期使用 Dexamethasone預防慢性肺疾病 (odds ratio, 35.83,信賴區間,7.03~183) 。本研究顯示,為了進一 步降低新生兒死亡率,必須加強週產期照顧及促進婦女健康來預防超早產兒及低出生體重兒的發生。 對於大於或等於24週之懷孕做出積極的醫療計劃應是合理可期的。最後,除非能證實生後早期使用 Dexamethasone預防慢性肺疾病為安全的治療,否則不應常規使用於超低出生體重兒。 |
英文摘要 | This retrospective study investigated the influence of perinatal factors on the limit of viability in extremely low birth weight (ELBW) infants. From January 1997 to May 1998, all infants weighing less than 1000 gm admitted to NICU of China Medical College Hospital were enrolled in this study. Stillborn infants and infants with congenital anomaly were excluded. The end outcome was survival of the infants (defined as alive at discharge). Eighty-four infants were included in this study. Their mean gestational age (GA) was 25.8�b1.76 weeks, mean birth weight (BW) was 772�b114 gm, and overall survival rate was 48.8%. The smallest intact survival was a female infant of GA 23 weeks and BW 530 gm. Early neonatal mortality rate (<7 days) was 26.2% (23/84). The cut off levels, below which mortality significantly increased, were GA<24 weeks and BW<700 gm (odds ratio, 6.11, confidence interval, 2.01 to 18.63 for GA; odds ratio, 2.65, confidence interval, 1.09 to 6.39 for BW). The two most significant factors which independently affected neonatal survival were GA<24 weeks and early neonatal dexamethasone treatment for the prevention of chronic lung disease (odds ratio, 9.24, confidence interval, 2.53 to 33.76 for GA; odds ratio, 35.83, confidence interval, 7.03 to 183 for dexamethasone treatment). We conclude that in order to further reduce neonatal mortality, efforts should be made in the areas of prenatal care and women's health to prevent extreme prematurity and low birth weight infants. In the case of an impending delivery of an ELBW infant, an active plan of management for all gestations�d24 weeks seems appropriate. Finally, unless it is proven to be safe, early neonatal dexamethasone treatment for prevention of chronic lung disease should not be routinely used in ELBW infants. |
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