■肺出血(PH)是一种危及生命的并发症,见于高发病率和死亡率的重病新生儿。关于发病率的数据很少,危险因素,以及撒哈拉以南国家肺出血新生儿的最终存活率,与高收入国家相比,医疗保健提供和设施在许多方面有所不同。因此,这项研究旨在确定发病率,确定风险因素,并描述低中等收入国家新生儿肺出血的结局。
■一项前瞻性数据收集的队列研究是在公众中进行的,博茨瓦纳的三级医院,公主码头医院(PMH)。从2020年1月1日至2021年12月31日入住新生儿病房的所有新生儿都被纳入研究。数据是使用在RedCap数据库上开发的清单收集的(https//:ehealth。ub.AC.bw/redcap)。肺出血的发生率计算为2年内每1,000名新生儿发生肺出血的新生儿数量。使用X2和Studentt检验进行分组比较。采用多因素logistic回归分析肺出血的独立危险因素。
■在研究期间有1,350名新生儿登记,其中729人为男性新生儿(54%)。平均(SD)出生体重为2,154(±997.5)g,胎龄为34.3(±4.7)周。此外,80%的新生儿在同一设施中分娩。入院新生儿肺出血发生率为54/1,350{4%[95%CI(3%-5.2%)]}。诊断为肺出血的死亡率为29/54(53.7%)。多因素logistic回归确定出生体重,贫血,脓毒症,震惊,播散性血管内凝血病(DIC),早产儿呼吸暂停,新生儿脑病,脑室内出血,机械通气,输血是肺出血的独立危险因素。
■这项队列研究确定了PMH新生儿肺出血的高发病率和高死亡率。多重危险因素,例如低出生体重,贫血,输血,早产儿呼吸暂停,新生儿脑病,脑室内出血,脓毒症,震惊,DIC,机械通气,被确定为PH的独立相关危险因素。
UNASSIGNED: Pulmonary hemorrhage (PH) is a life-threatening complication seen in very sick newborns with high morbidity and mortality. There is little data on the incidence, risk factors, and ultimate survival of newborns with pulmonary hemorrhage in sub-Saharan countries, where the healthcare provision and facility differ in many ways compared to high-income countries. Hence, this study aimed to determine the incidence, identify the risk factors, and describe the outcome of pulmonary hemorrhage in newborns in a low middle income country setting.
UNASSIGNED: A cohort study with prospective data collection was conducted in a public, tertiary-level hospital in Botswana, the Princess Marina Hospital (PMH). All newborns admitted to the neonatal unit from 1 January 2020 to 31 December 2021 were included in the study. Data were collected using a checklist developed on the RedCap database (https//:ehealth.ub.ac.bw/redcap). The incidence rate of pulmonary hemorrhage was calculated as the number of newborns who had pulmonary hemorrhage per 1,000 newborns in the 2-year period. Group comparisons were made using X2 and Student\'s t-tests. Multivariate logistic regression was used to identify risk factors independently associated with pulmonary hemorrhage.
UNASSIGNED: There were 1,350 newborns enrolled during the study period, of which 729 were male newborns (54%). The mean (SD) birth weight was 2,154(±997.5) g, and the gestational age was 34.3 (±4.7) weeks. In addition, 80% of the newborns were delivered in the same facility. The incidence of pulmonary hemorrhage was 54/1,350 {4% [95% CI (3%-5.2%)]} among the newborns admitted to the unit. The mortality rate in those diagnosed with pulmonary hemorrhage was 29/54 (53.7%). Multivariate logistic regression identified birth weight, anemia, sepsis, shock, disseminated intravascular coagulopathy (DIC), apnea of prematurity, neonatal encephalopathy, intraventricular hemorrhage, mechanical ventilation, and blood transfusion as risk factors independently associated with pulmonary hemorrhage.
UNASSIGNED: This cohort study identified a high incidence and mortality rate of pulmonary hemorrhage in newborns in PMH. Multiple risk factors, such as low birth weight, anemia, blood transfusion, apnea of prematurity, neonatal encephalopathy, intraventricular hemorrhage, sepsis, shock, DIC, and mechanical ventilation, were identified as independently associated risk factors for PH.