背景:低出生体重(LBW)会增加婴儿的发病率和死亡率,并且是主要的公共卫生问题,尤其是在资源受限的环境中。这项回顾性研究的目的是评估印度西部新生儿重症监护病房(NICU)转诊的LBW新生儿的结局和发病率。
方法:本研究调查了2016年9月15日至2017年9月15日期间出生时体重低于2公斤的新生儿的医疗记录。关于长期结果的数据,临床表现,发病率,死亡率,收集和分析人口统计学变量。描述性统计用于将连续变量表示为平均值和标准偏差(SD),而分类变量以频率和百分比表示。进行了双变量和多变量逻辑回归分析,以发现LBW婴儿的胎龄和主要发病率之间的关联。
结果:在4710名新生儿中,327例(6.9%)为LBW。LBW婴儿的主要发病率是呼吸窘迫综合征(RDS)153(46.8%),新生儿黄疸92(28%),败血症81(25%),造成58人(17.7%)死亡。较低的胎龄与RDS的校正几率显着相关(<28周:参考;28-32周:校正优势比(AOR)0.07,95%置信区间(CI)0.01-0.33;≥37周:AOR0.001,95%CI0.00005-0.02)和RDS相关死亡率(28-32周:AOR0.26,95%CI0.06-1.13;≥37周:AOR0.07,95%CI0.01在250例成功出院的病例中,12个月时,18(13.7%)的权重低于第三百分位数,9人(6.8%)未能通过神经发育筛查。
结论:在这种情况下,LBW婴儿会出现明显的发病率,死亡率,以及长期增长和发展效应。为了减轻与LBW相关的负担,改善新生儿护理设施,感染控制方案,重点干预至关重要。
BACKGROUND: Low birth weight (LBW) increases infant morbidity and mortality and is a major public health concern, especially in resource-constrained settings. The purpose of this retrospective study was to assess the outcomes and morbidities related to LBW neonates referred to a neonatal intensive care unit (NICU) in Western India.
METHODS: The present study examined the medical records of newborns weighing less than 2 kg at birth who were admitted to the NICU between September 15, 2016, and September 15, 2017. Data on long-term outcomes, clinical manifestations, morbidities, mortality, and demographic variables were gathered and analyzed. Descriptive statistics were used to present continuous variables as mean and standard deviation (SD), while categorical variables were presented as frequencies and percentages. Bivariate and multivariate logistic regression analyses were carried out to find the association between gestational age and major morbidities among LBW babies.
RESULTS: Of 4710 births, 327 (6.9%) were LBW. The leading morbidities of LBW babies were respiratory distress syndrome (RDS) 153 (46.8%), neonatal jaundice 92 (28%), and septicemia 81 (25%), contributing to 58 (17.7%) deaths. Lower gestational age was associated with significantly higher adjusted odds of RDS (<28 weeks: reference; 28-32 weeks: adjusted odds ratio (AOR) 0.07, 95% confidence interval (CI) 0.01-0.33; ≥37 weeks: AOR 0.001, 95% CI 0.00005-0.02) and RDS-related mortality (28-32 weeks: AOR 0.26, 95% CI 0.06-1.13; ≥37 weeks: AOR 0.07, 95% CI 0.01-0.43). Among 250 successfully discharged cases, at 12 months, 18 (13.7%) had a weight below the 3rd percentile, and 9 (6.8%) failed the neurodevelopmental screening.
CONCLUSIONS: LBW infants in this setting experience significant morbidities, mortality, and long-term growth and developmental effects. To alleviate the burden associated with LBW, improved neonatal care facilities, infection control protocols, and focused interventions are essential.