High-risk Factors For Secondary Apnea In Premature Infants

1.Background and ObjectiveWith the advancement of medical technology in the field of obstetrics and neonatology,the survival rate of preterm infants has gradually increased,but the incidence of complications is still high,such as apnea in preterm infants,brain damage in preterm infants,necrotizing enterocolitis,and neonatal respiratory distress(NRDS),etc.Among them,apnea in premature infants is extremely common,and the harm it causes needs to be paid great attention.Its repeated attacks may cause softening of the ventricle white matter around the premature infants,damage to the auditory center,leading to cerebral palsy,high-frequency deafness,etc,may even lead to death.There are many causes of apnea in preterm infants,including primary apnea in preterm infants and secondary apnea in preterm infants.In neonatal departments,especially the neonatal intensive care unit(NICU),primary apnea is more common and can occur in preterm infants of any gestational age and may occur at any age after birth.Therefore,this article intends to explore the common risk factors of secondary apnea in preterm infants,analyze the high-risk factors that eventually cause the disease,so as to attract the attention of the majority of neonatal medical workers,and actively control the relevant high-risk factors.In this way,it is efficient preventing the occurrence of secondary apnea in preterm infants,significantly improving the survival rate and improving the prognosis of preterm infants.2.MethodThis study collected 442 premature infants born in the obstetrics department of the Second Affiliated Hospital of Dalian Medical University and admitted to the neonatal department from September 2013 to September 2019.A total of 376 premature infants who met the research standard(met the inclusion criteria and excluded by exclusion criteria)were included.The are divided into a case group and a control group according to the diagnostic criteria of the 5th edition of Practical Neonatology.Premature infants of case group had secondary apnea after birth,a total of 84 cases,premature infants of control group were no apnea-related symptoms and signs after birth,a total of 292 cases.Retrospective statistical analysis was performed on the case group and the control group.SPSS 23.0 statistical software was used.In univariate analysis,the measurement data(in accordance with the normal distribution)were expressed as mean±standard deviation(x±s).The chi-square test was used for the count data.If P<0.05,it was considered statistically significant,and then the relevant factors that were statistically significant through univariate analysis were entered into the analysis model for multi-factor Logistic stepwise regression analysis.3.Result1.Secondary apnea in preterm infants can occur in preterm infants of any gestational age.2.The independent sample t-test results of the mean gestational age of two preterm infants suggest t=-0.778,P=0.437(>0.05),and the independent sample t-test results of the average birth weight suggest t=-0.363,P=0.717(>0.05).It shows that there is no statistical difference in gestational age and birth weight between the case group and the control group.3.There was statistical difference between patients in case group with neonatal respiratory distress syndrome(X~2=4.607,P=0.032),brain injury(X~2=9.749,P=0.002),neonatal sepsis(X~2=4.677,P=0.031),low Calcium(X~2=4.580,P=0.032),acidosis(X~2=8.437,P=0.040),hypertension during pregnancy(X~2=8.176,P=0.004),oligohydramnios during pregnancy(X~2=4.006,P=0.045)and patients in control group with above illness.4.Logistic stepwise regression analysis showed that acidosis(OR=1.84,95%CI1.096?3.090),premature infant brain damage(OR=2.06,95%CI 1.214?3.496),pregnancy-induced hypertension(OR=2.036,95%CI 1.187?3.492),P values are all less than 0.05.4.Conclusions1.Secondary apnea can occur in preterm infants of any gestational age.2.The incidence of secondary apnea in premature infants is irregular with the change of gestational age and birth weight.3.Secondary apnea in preterm infants is statistically associated with brain damage,acidosis,hypocalcemia,RDS,neonatal sepsis,hypertension during pregnancy,and oligohydramnios during pregnancy.4.Brain injury,acidosis and hypertension during pregnancy in preterm infants are high-risk factors for secondary apnea in preterm infants.Active prevention of such diseases can significantly reduce the incidence of secondary apnea in preterm infants.