| Objective:The purpose of this study is to understand more about clinical characteristics, improve the management, and lower the hospitalization costs of very low birth weight infant(VLBWI) by retrospectively analyzing the epidemiology, clinical complication, perinatal high risk factor, length of hospitalization and financial burden.Methods:The clinical data of 111 cases of VLBWI born from January 2013 to December 2015 were recruited including birth weight, gender, maternal disease, short term outcomes, complications, some treatment, etc. SPSS 17.0 software was used to do the statistics. Multiple logistic regression analysis was conducted to determine the high risk factors for poor outcome.Results:(1)Total 111 cases of VLBWI were collected from 2013 to 2015 born in our hospital. The incidence VLBWI was 1.23%, with mortality of 10.8%, withdraw of 10.8%, survival of 78.4%. (2) The average birth weight(BW) was 1229.1±200.2g with most of them ranged from 1000-1499g. Among them, 16.2%were extremely low birth weight infant (ELBWI). The average gestational age(GA) was 31.3±2.4 weeks, with most of them ranged from 28-34 weeks. Infants with GA>28 weeks accounted for only 8.1%. (3) The first 5 complications occurred in VLBWI were hyperbilirubinemia, anemia, intracranial ventricular hemorrhage (IVH), pneumonia and neonatal asphyxia. The incidence of patent ductus arteriosus (PDA), pneumonia and neonatal respiratory distress syndrome (RDS) were inversely proportional to GA (P<0.05). Multiple pregnancy, PDA and mechanical ventilation within 2 days of admission to in neonatal intensive care unit (NICU) were the risk factors of poor outcome. (4) The average maternal age was 30.7±6.0 years with 27 cases (24.3%) older than >35 years. Infants of in vitro fertilization and embryo transfer(IVF-ET) and multiple pregnancy accounted for 18% and 38.7% respectively. Apgar score <7 at 5 min accounted for 21.6%. The incidence of cesarean section and fetal distress were 56.8% and 30.6% respectively. Premature rupture of membrane (PROM)>24 hrs. accounted of 18.9%. Antenatal steroid supplement was seen in 55.9% infants. Pregnancy-induced hypertension and gestational diabetes mellitus accounted for 33.3% and 18.0% respectively. Small for gestational age(SGA) accounted for 60.4%. (5) The rate of ventilation support within 2 days of admission and PS replacement were 34.2% and 47.0% respectively, which were inversely proportional to GA and BW. The rate non-invasive ventilator within 2 days of admission was 27.0%, which was inversely proportional to BW, with more common from 28 to<32 weeks (P<0.05). (6) The average length of hospitalization was 43.0 days. The average hospitalization cost was 61.7 thousand with median of 44.4 thousand, which was higher than that in late preterm infant (LPI) and full term infant (FTI) (p<0.05), and inversely proportional to GA and BW.Conclusion:(1) VLBWI is a special population with high mortality and should be paid close attention. (2) The first 5 complications of VLBWI are hyperbilirubinemia, anemia, IVH, pneumonia and neonatal asphyxia. (3) Mult-iple pregnancy, PDA and ventilation support within 2 days of admission are the risk factors of poor outcome for VLBWI. (4) Pregnancy hypertension is one of the most common reason of VLBWI. (5) VLBWI bear the higher average length hospitalization and cost burden which is inversely proportional to GA and BW. |
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