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Archives of disease in childhood. Fetal and neonatal edition 改善 <32 孕周早产儿重度脑室内出血的发生率趋势: 一项队列研究。

影响因子：6.643 DOI：10.1136/archdischild-2018-316664

作者： Yeo KT,Thomas R,Chow SS,Bolisetty S,Haslam R,Tarnow-Mordi W,Lui K,Australian and New Zealand Neonatal Network. 发表时间：2020-07-10 14:30:39

from：《Archives of Disease in Childhood-Fetal and Neonatal Edition》

keywords： Yeo KTThomas RChow SSBolisetty SHaslam RTarnow-Mordi WLui KAustralian and New Zealand Neonatal Network.

关键词：流行病学新生儿学

Abstract

OBJECTIVE:To describe the trend and risk factors for severe intraventricular haemorrhage (IVH) among infants <32 weeks gestation. DESIGN:Population-based cohort study. SETTING:Australia and New Zealand. PATIENTS:All preterm infants <32 weeks gestation in the Australian and New Zealand Neonatal Network (ANZNN) from 1995 to 2012. INTERVENTIONS:Comparison of IVH incidence between 6-year epochs. MAIN OUTCOME MEASURES:Overall IVH and severe IVH incidence. RESULTS:A total of 60 068 infants were included, and overall survival to discharge increased from 89% to 93% over the three epochs. As the percentage of infants with IVH decreased from 23.6% to 21.3% and 21.4% (p<0.001) from epoch 1 to 3, respectively, fewer survivors had severe IVH (4.0%, 3.3% and 2.8%, respectively, p<0.001). Over time, there were fewer antenatal complications, higher antenatal steroid usage and more caesarean-section births. Fewer infants were intubated at birth, had low 5 min Apgar score, had sepsis or pneumothorax needing drainage. Adjusted for perinatal confounders, there was significant reduction in odds of severe IVH from epoch 1 to 3 (adjusted OR (AOR) 0.8, 95% CI 0.7 to 0.9). Factors associated with development of severe IVH include no antenatal steroids (AOR 1.7, 95% CI 1.5 to 1.9), male (AOR 1.3, 95% CI 1.2 to 1.4), 5 min Apgar score <7 (AOR 2.0, 95% CI 1.9 to 2.2), intubated at birth (AOR 2.0, 95% CI 1.8 to 2.2), extremely low gestational age (AOR 4.0, 95% CI 3.7 to 4.4), outborn (AOR 1.6, 95% CI 1.5 to 1.8) and vaginal delivery (AOR 1.4, 95% CI 1.3 to 1.6). CONCLUSIONS:Along with increased survival among infants born <32 weeks gestation, the incidence of severe IVH has decreased over the 18 years, especially in the most recent period. This coincided with reduction in rates of risk factors for severe IVH development.

摘要

目的: 探讨妊娠 <32 周婴儿发生重度脑室内出血 (IVH) 的趋势和危险因素。设计: 基于人群的队列研究。设置: 澳大利亚和新西兰。患者: 1995 年至 2012 年澳大利亚和新西兰新生儿网络 (ANZNN) 中所有妊娠 <32 周的早产儿。干预措施: 6 年时期IVH发生率的比较。主要结局指标: 总体IVH和严重IVH发生率。结果: 共纳入 60 068 例婴儿，三个时期的总存活率从 89% 提高到 93%。随着IVH婴儿的百分比分别从 23.6% 下降到 21.3% 和 21.4% (p<0.001)，从epoge 1 下降到 3，严重IVH的幸存者更少 (4.0%，3.3% 和 2.8%，分别为p<0.001)。随着时间的推移，产前并发症更少，产前类固醇使用率更高，剖腹产分娩更多。出生时插管的婴儿较少，5 分钟Apgar评分低，有败血症或气胸需要引流。校正围产期混杂因素后，重度IVH的几率显著降低，从epoch 1 降至 3 (校正OR (AOR) 0.8，95% CI 0.7 至 0.9)。与严重IVH发生相关的因素包括无产前类固醇 (AOR 1.7，95% CI 1.5 至 1.9)，男性 (AOR 1.3，95% CI 1.2 至 1.4)，5 min Apgar评分 <7 (AOR 2.0，95% CI 1.9 ~ 2.2)，出生时插管 (AOR 2.0，95% CI 1.8 ~ 2.2)，极低孕龄 (AOR 4.0，95% CI 3.7 ~ 4.4) 、早产 (AOR 1.6，95% CI 1.5 ~ 1.8) 和阴道分娩 (AOR 1.4，95% CI 1.3 ~ 1.6)。结论: 随着妊娠 <32 周出生的婴儿存活率的增加，重度IVH的发生率在 18 年中有所下降，尤其是在最近一段时间。这与严重IVH发展的危险因素发生率的降低相一致。

期刊介绍

《Archives of Disease in Childhood-Fetal and Neonatal Edition》 (点击进入期刊详情)

英文简介 : The Fetal and Neonatal Edition of the Archives of Disease in Childhood is published bimonthly with the aim of ensuring that perinatal-neonatal paediatrics maintains its strong academic research base and to bring together in one journal quality research and reviews in this field. Original research papers focus on fetal and neonatal physiology and clinical practice, genetics, perinatal epidemiology and neurodevelopmental outcomes. The scientific quality of published material is very high and the review articles are subject to the same expert peer review as the original papers.

中文简介 : （来自Google、百度翻译）《儿童疾病档案》的胎儿和新生儿版每月出版两期，目的是确保围产儿-新生儿儿科保持其强大的学术研究基础，并将该领域的优质研究和评论汇集在一份期刊上。最初的研究论文集中在胎儿和新生儿的生理和临床实践，遗传学，围产期流行病学和神经发育结果。发表的论文具有很高的科学质量，所发表的评论文章必须经过与原论文相同的专家同行评审。

CIRCULATION RESEARCH 期刊中科院评价数据

新中科院分区

大类(学科)	小类(学科)	学科排名
医学	PEDIATRICS (儿科)	7/124

新发布的期刊年发文量

年度总发文量	年度论文发表量	年度综述发表量
89	75	14

总被引频次 :4193

特征因子 : 0.008410

影响因子趋势图

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