Analysis Of Complications In Early And Middle Preterm Infants And Establishment Of Prediction Model Of Brain Injury In Preterm Infants

Objective:1.Through the study of the clinical data of preterm infants with gestational age of 28weeks≤gestational age≤33⁺⁶ weeks in the Department of Neonatology,Affiliated Hos-pital of Yan’an University,in order to better understand the possible complications.2.To study and analyze the high risk factors of brain injury in premature infants,and to establish a predictive model of its risk on this basis,so as to provide theoretical basis for early diagnosis of clinicians.Research objects and methods:1.Collect the basic data of premature infants with 28 weeks≤gestational age≤33⁺⁶weeks hospitalized in the Department of Neonatology,Affiliated Hospital of Yan’an University from January 1,2018 to December 31,2022,maternal perinatal conditions,complications of premature infants,laboratory test results and treatment after birth.2.The characteristics of clinical complications in premature infants were analyzed according to gestational age and weight.3.The original data were randomly divided into training data sets and validation data sets at a ratio of 7:3.According to the occurrence of brain injury,the training set was divided into brain injury group and non-brain injury group,and the related factors of brain injury in premature infants were analyzed.Univariate analysis,lasso regression and multivariate logistic regression were used to screen variables.Finally,the receiver oper-ating characteristic curve and calibration curve were used to evaluate the early predictive efficacy of brain injury in premature infants,and the clinical decision curve was used to evaluate the clinical practicability.Results :1.Analysis of clinical complications of premature infants1.1 This study found that the common complications of premature infants with 28weeks≤gestational age≤33⁺⁶ weeks were:neonatal pneumonia,neonatal hyperbiliru-binemia,and neonatal anemia.1.2 There were significant differences in apnea,neonatal asphyxia,NRDS,BPD,PDA,anemia,hypoglycemia,NEC and BIPI among different gestational age and weight（P<0.05）.2.Construction and validation of a predictive model for brain injury in preterm in-fants2.1 Results of single factor analysis:gestational age,birth weight,mode of delivery,1,5 min Apgar score,prenatal use of glucocorticoids,maternal chorioamnionitis,fetal distress,sepsis,neonatal asphyxia,NRDS,BPD,PDA,NEC,neonatal anemia,hypogly-cemia,p H,Pa CO₂,BE were associated with the occurrence of BIPI.2.2Multivariate logistic analysis showed that:gestational age,birth weight,mode of delivery,5 min Apgar score,hypoglycemia,p H,prenatal use of glucocorticoids,fetal distress were independent influencing factors of BIPI.2.3The area under the ROC curve（AUC value）of the training group and the veri-fication group was greater than 0.8,and the discrimination was good.2.4.Model calibration curve is close to the standard curve,indicating good calibra-tion.Conclusion:1.This study found that the common clinical complications of premature infants were:neonatal pneumonia,neonatal hyperbilirubinemia,neonatal anemia.2.Compared with premature infants with 32≤gestational age≤33⁺⁶ weeks,prem-ature infants with 28≤gestational age≤31⁺⁶ weeks are more likely to have clinical complications.3.28 weeks≤gestational age≤31⁺⁶ weeks,birth weight<1 500 g,vaginal delivery,hypoglycemia,p H<7.20,fetal distress were independent risk factors for BIPI.Adequate prenatal use of glucocorticoids and 5 min high Apgar score are protective factors for BI-PI.4.The established BIPI prediction model has good discrimination and calibration.