Clinical Analysis Of Extremely Low Birth Weight Infants And Extremely Preterm Infants

Objective:The purpose of this study is to analyze the basic information,perinatal factors,complications during hospitalization,main treatment measures and prognosis,etc of extremely low birth weight infants(ELBWI)and extremely preterm infants(EPI),thus,provide clinical information to improve treatment for ELBWI and EPI.Methods:Retrospective analysis methods was used in this study.Clinical data was collected for 35 ELBWI and EPI admitted to the division of neonatology,Department of Pediatrics,the First Affiliated Hospital of Guangxi Medical University within 24 hours after birth from March 2013 to March2017.The SPSS 16.0 software was used to do the statistics,logistic regression analysis was performed on the factors that may affect the prognosis of ELBWI and EPI.Results:1、A total of 35 cases of ELBWI and EPI(29ELBWI,16 EPI,10 both ELBWI and EPI)were recruited to this study.Among 35 cases,15 cases were male and 20 female.The ratio of male to female was 1:1.3.Gestational age was from 25 weeks to 33+1 weeks with a mean gestational age of 28.5±2.0wk.Birth weight was from 759 g to 1290 g and the mean birth weight was 932.7±114.3g.2、Perinatal information:Of 35 cases infants in this study,24(68.6%)were from natural conception,11(31.4%)infants were from artificial assisted reproduction.The incidence of multiple births was 60.0%(n=21),among which,twins account for 95.2%.The major complications during pregnancy including hypertension,premature rupture of membranes and gestational diabetes.Fetal distress was found in 9 cases(25.7%).Antenatal steroids(dexamethasone)was given in 25 cases(71.4%)to improve fetal lung maturity.3、Of 35 cases of ELBWI and EPI,abandon treatment occurred in 7 cases with a abandon rate of 20%.Amount these 7 cases,treatment has been given up without any effort due to parents’ decision within 48 hours after birth in 5 cases,accounting for 71.4% of total abandoned cases.Total 23 cases survived by standard treatment with the survival rate of 65.7%.The survival rate of ELBWI was 65.5%,of EPI was 62.5%.4、Of 35 cases of ELBWI and EPI,the incidence of complications were:neonatal respiratory distress syndrome(NRDS)was 82.9%(n=29),anemia82.9%(n=29),hyperbilirubinemia 82.9%(n=29),pneumonia 77.1%(n=27),apnea71.4%(n=25),bronchopulmonary dysplasia(BPD)62.9%(n=22),intravascular hemolysis(IVH)57.1%(n=20),sepsis 54.3%(n=19),retinopathyof prematurity(ROP)48.6%(n=17),patent ductus arteriosus(PDA)31.4%(n=11),necrotizing enterocolitis 2.9%(n=1).5、Treatment: Of 35 cases of ELBWI and EPI,pulmonary surfactant(PS)replacement was given in 29 infants(82.9%).Within two days after admitted,28cases(80.0%)required respiratory support,including invasived mechanicalventilation and nasal continuous positive airway pressure(CPAP).During hospitalization,29 cases(82.9%)required red blood cell transfusion.6、In survival cases,the average days of hospitalization was 72.1±21.2days,average hospital charge was 11.7±6.0 million RMB.7、Multivariate logistic regression analysis found no risk factors affected prognosis in ELBWI and EPI.Conclusions:1、ELBWI and EPI are high risk groups in neonate with a relative high mortality and abandon rate.2、Higher incidence of complication occurs during hospitalization in ELBWI and EPI.The highest incidence of complications are NRDS,anemia and hyperbilirubinemia.