Clinical Epidemiology Investigation Of Preterm Infants

Objective: In recent years,with the development of perinatal medicine,preterm infants are taken more seriously by scholars at home and abroad.With the continuous improvement of the neonatal treatment technology,preterm infants,especially very low birth weight infants and extremely low birth weight infants,the survival rate is gradually increased.However,a series of complications come to be the obvious problem which may affect the prognosis of preterm infants.This subject is to analysis different group of gestational age and birth weight of preterm infants,risk factors of preterm birth,the distribution of complications of preterm infants and prognosis relevant factors by analyzing the clinical data of preterm infants in our hospital retrospectively.In order to provide evidence based research for reducing premature morbidity and mortality in our hospital and contribute improving quality of life of preterm infants.Methods: Questionaire of preterm infant hospitalized in NICU of Second hospital of Hebei Medical university was designed.The clinical data of 445 preterm infants survived hospitalized in our NICU after birth within 24 hours from January 1 of 2014 to December 31 of 2014 were collected to statistics the perinatal situation,the distribution of gestational age,the distribution of birth weight,the treatment,the incidence of complications and the prognosis at the 28 th day after birth,all the data were analyzed by the statistical Package for SPSS 17.0,measurement data were presented as mean ± standard deviation,P<0.05 means having statistic significance.Results: Total 445 preterm infants were admitted into our NICU after birth within 24 hours from January 1 of 2014 to December 31 of 2014.Specific circumstance as follows: 1 This data collected with a gender constituent ration of 1.23:1(245 boys:200 girls).According to gestational age,the preterm infants were enrolled into different groups: 10 of them(2.3%)were born at gestational age ?28 weeks;130(29.2%)were born at gestational age of 28+1~32 weeks;199(44.7%)were born at gestational age of 32+1~35 weeks;106(23.8%)were born at gestational age of 35+1~36+6 weeks.The average gestational age was 32.84±2.18 weeks,the smallest gestational age was 26+5 weeks.2 In this study,according to birth weight,the preterm infants were enrolled into different groups: 7 infants<1000g(1.6%),95 infants were between 1000g~ 1499g(21.4%),274 infants were between 1500g~2499g(61.6%),69 infants ?2500g(15.5%),the average birth weight was 1899±597g,the smallest birth weight was 650 g.The largest birth weight was 4600 g.3 In this study,110 infants were diagnosed with asphyxia depending on the Apgar score after birth,the incidence of neonatal asphyxia was 24.7%,including 11(2.5%)severe asphyxia.The incidence of neonatal asphyxia was increasing with the decreasing of the gestational age.4 In this study,the most common factor of preterm labour was the hypertension syndrome of pregnancy(42.3%),followed by multiple pregnancy(22.7%),the premature rupture of membrances(17.3%),scar uterus(13.0%),diabetes mother(10.6%),placenta previa(7.4%),placenta abruption(4.0%),pregnancy with thrombocytopenia(3.4%),anemia(3.2%),acute fatty liver(1.6%),heart disease(1.4%).5 In this study,the most common neonatal disease was hyperbilirubinemia(63.4%),respiratory system diseases(51.5%),the circulatory system diseases(43.8%),electrolyte disorder(26.1%).6 The incidence of neonatal diseases changed with the variation of the gestational age or birth weight.With the increase of gestational age or birth weight,the incidence of hyperbilirubinemia between the different groups has no statistic difference(P>0.05),the incidence of other diseases between different groups has statistic difference.(P<0.05).7 With the increase of gestational age or birth weight,the incidence of some disease was decreased,such as the neonatal pneumonia,apnea,neonatal respiratory distress syndrome,pulmonary hemorrhage,upper gastrointestinal bleeding,feeding intolerance,Swallowing syndrome,cholestasis,necrotizing enterocolitis.There is statistic difference between groups.8 In this study,173 preterm infants(38.9%)were given respiratory support,158(35.5%)inhaled oxygen,122(27.4%)were supported with CPAP,66(14.8%)were supported with mechanical ventilation.90(20.2%)received PS treatment.9 With the increase of gestational age or birth weight,the hospital stays was shorten.With the increase of gestational age or birth weight,the short term outcome of the preterm infant at 28 th day of life.was elevated.Conclusions:1 In this study,the most common causes of premature labour were the hypertension syndrome of pregnancy,multiple pregnancy and premature rupture of membranes.2 The most common neonatal disease was hyperbilirubinemia,respiratory system diseases and circulatory system diseases.3 Respiratory support and PS treatment improved the survive rate significantly in preterm infants.4 Gestational age and birth weight of premature are highly associated with the length of stay in the hospital,the incidence of complications and the prognosis at the 28 th day after birth.