背景:新生儿窒息是新生儿早期死亡的主要原因,每年约有90万人死亡。评估生存率,窒息新生儿的恢复时间和死亡率预测因素可以帮助决策者设计,工具,并评估方案,以实现到2030年将新生儿死亡率降低到12/1,000活产的可持续发展目标。目前的研究试图确定生存状态,恢复时间,和新生儿窒息的预测因素。
方法:在DebreBerhan综合专科医院进行的回顾性随访研究,从5月20日到6月20日,2023年1月1日起使用NICU窒息婴儿的记录,2020年12月31日,2022年,涉及样本量为330。使用GoogleForm中创建的预结构化问卷来收集数据,STATA版本14.0用于数据输入和分析,分别。Kaplan-Meier存活曲线,对数秩检验,并计算中位时间。拟合了多变量Cox比例风险回归模型,以确定恢复时间的预测因子。如果它们的P值小于0.05,则变量具有统计学显著性。
结果:三百三十名入院窒息新生儿共随访2706天,至少1天至18天。生存总发生率密度率为9.9/100个新生儿观察天(95%CI:8.85-11.24),中位恢复时间为9天(95%CI:0.82-0.93)。延长劳动力(调整后的危险比(AHR:0.42,95CI:0.21-0.81),正常出生体重(AHR:2.21,95%CI:1.30-3.70),非意识改变(AHR:2.52,CI:1.50-4.24),新生儿的非抑郁性Moro反射(AHR:2.40,95CI:1.03-5.61),第一阶段HIE(AHR:5.11,95%CI:1.98-13.19),通过鼻子直接给氧(AHR:4.18,95%CI:2.21-7.89)被发现是窒息新生儿恢复时间的独立预测因素。.
结论:在目前的调查结果中,与其他发现相比,恢复时间延长.这意味着早期诊断,在婴儿并发缺氧缺血性脑病(HIE)的最高阶段之前,必须进行严格的监测和及时提供适当的措施,并建议管理并发症以加快恢复时间并增加新生儿的生存率。
BACKGROUND: Neonatal asphyxia is a leading cause of early neonatal mortality, accounting for approximately 900,000 deaths each year. Assessing survival rates, recovery time and predictors of mortality among asphyxiated neonates can help policymakers design, implement, and evaluate programs to achieve the sustainable development goal of reducing neonatal mortality to 12/1,000 live births by 2030. The current study sought to ascertain the survival status, recovery time, and predictors of neonatal asphyxia.
METHODS: A retrospective follow-up study conducted in Debre Berhan Comprehensive Specialized Hospital, which carried out from May 20th to June 20th, 2023 using records of asphyxiated babies in NICUs from January 1st, 2020 to December 31st, 2022, involving a sample size of 330. Pre-structured questionnaires created in Google Form were used to collect data, and STATA Version 14.0 was utilized for data entry and analysis, respectively. The Kaplan-Meier survival curve, log rank test, and median time were calculated. A multivariable Cox proportional hazards regression model was fitted in order to determine the predictors of time to recovery. Variables were statistically significant if their p-value was less than 0.05.
RESULTS: Three hundred thirty admitted asphyxiated neonates were followed a total of 2706 neonate -days with a minimum of 1 day to 18 days. The overall incidence density rate of survival was 9.9 per 100 neonates\' days of observation (95% CI: 8.85-11.24) with a median recovery time of 9 days (95% CI: 0.82-0.93). Prolonged labor (Adjusted hazard ratio (AHR: 0.42,95%CI:0.21-0.81), normal birth weight (AHR:2.21,95% CI: 1.30-3.70),non-altered consciousness (AHR:2.52,CI:1.50-4.24),non-depressed moro reflex of the newborn (AHR:2.40,95%CI: 1.03-5.61), stage I HIE (AHR: 5.11,95% CI: 1.98-13.19),and direct oxygen administration via the nose (AHR: 4.18,95% CI: 2.21-7.89) were found to be independent predictors of time to recovery of asphyxiated neonates..
CONCLUSIONS: In the current findings, the recovery time was prolonged compared to other findings. This implies early diagnosis, strict monitoring and provision of appropriate measures timely is necessary before the babies complicated into the highest stage of hypoxic -ischemic encephalopathy(HIE) and managing complications are the recommended to hasten recovery time and increase the survival of neonates.