| Objective: The goal of this study is to investigate the clinicalcharacteristics of extremely low birth weight infants (ELBWI) nearlytwenty years, to summarize medical experiences, to analyze risk factors formortality and treatment abandon, to evaluate long term outcomes.Methods： In this retrospective study we collected a total of87ELBWI cases enrolled the neonatal department of Children’s Hospital ofChongqing Medical University between July1994and April2013. Theywere grouped by birth weight and gestational age, described their clinicalcharacteristics, analyzed their clinical outcomes. Through the comparisonof their perinatal history and complications grouped by different clinicaloutcomes, found risk factors for mortality and treatment abandon. Throughthe comparison of clinical outcomes and their long term follow-up groupedby different treatment year, found the change of treatment and outcomes.Results：1.Average birth weight was (881.62±79.32)g,(620~990)g,average gestational age was (28.82±2.24)week,(25+3~34)week.2. The hospital admission was mainly (58/87) by the ambulance fromour hospital. The way of discharge was mainly (62/87) treatment abandoned by their parents. Average length of stay was (20.72±32.83) days,(1~149) days.3. The ELBWI were mainly (51/87) multiple gestation and small forgestation count for43/87cases, test tube babies count for20/87cases.4. Premature rupture of membranes and pregnancy-inducedhypertension attributed for most preterm delivery, but still4.6%(4/87)preterm delivery caused by unknown reason.5. There was34/87cases used antenatal corticosteroids,10/87cases used pulmonary surfactant in delivery room.6. Average birth length was (34.41±2.99) cm. Average birth headcircumference was (24.71±1.88) cm. All these clinical measures were positive correlation with birth weight and gestation age.7. Average total protein level was (41.44±8.80) g/L and positivecorrelation with birth weight and gestation age.8. The main complication of ELBWI was involved respiratory disease system.36/87cases used pulmonary surfactant after hospitalizedand52/87cases used mechanical ventilation during hospitalized.9. The survival rate was21.84%, in-hospital mortality was6.90%, treatment abandon rate was71.26%. The survival rate was positive correlation with birth weight and gestation age while the treatmentabandon rate was negative correlation with birth weight and gestatio n age. Different treatment year had different clinical outcomes.10. Good prognosis group had higher gestation age, hematocrit and total protein level as well as higher ratio of test tube babies,usage of antenatal corticosteroids and mothers with pregnancy-inducedhypertension. The difference was statistically significant.11. Good prognosis group had less usage of mechanical ventilation and epinephrine, more infusion of albumin, red cell suspensionand immunoglobulin. The difference was statistically significant.12. Poor prognosis group had higher complication of NRDS, respiratory failure, apnea, pulmonary hemorrhage, metabolic acidosis andcongestive heart failure while lower complication of BPD, sepsis, anemia, ROP, hyperbilirubinemia, hypokalemia, cholestasis, hepaticfunction lesion, myocardial lesion, feeding intolerance. The differencewas statistically significant.13.11/19cases of good prognosis group were followed by telephone while8/19cases lost contact. The oldest one we followed upwas11year and4month old and his score of Wechsler IntelligenceScale for Children were87for verbal intelligence quotient,103forperformance intelligence quotient and96for full intelligence quotient.The youngest one was1year and3month old and his score ofGesell Developmental Schedules were81for adaptive Developmental quotient,69for gross motor Developmental quotient,80for fine motor Developmental quotient,62for language and95for personal-social skills Developmental quotient.Conclusion: ELBWI is a particular group of preterm infants, theyneed more attention when evaluate critical cases and clinical management.Assessment of their clinical characteristics contributes to judge prognosis.Predictive communicate with parents and weigh the pros and cons together,to improve survival rate and quality of life. |
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