Outcomes of very low birth weight infants at discharge: a multicentered cross-sectional study of 25 tertiary neonatal intensive care units in China
10.3760/cma.j.issn.1007-9408.2018.06.007
- VernacularTitle: 我国25家Ⅲ级新生儿重症监护病房极低出生体重儿出院结局的横断面调查
- Collective Name:REduction of Infection in Neonatal intensive care units using the Evidence-based Practice for Improving Quality (REIN-EPIQ) Study Group
- Publication Type:Journal Article
- Keywords:
Intensive care units, neonatal;
Infant, very low birth weight;
Mortality;
Incidence;
Cross-sectional studies
- From:
Chinese Journal of Perinatal Medicine
2018;21(6):394-400
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the mortality and incidence of major diseases in preterm very low birth weight infants (VLBWI) in order to provide baseline data for clinical decision making and further epidemiological studies.
Methods:This was a multicentered cross-sectional study and a sub-analysis of baseline data from "REduction of Infection in Neonatal intensive care units using the Evidence-based Practice for Improving Quality (REIN-EPIQ)" study, which was a multicentered cluster-randomized controlled study. This study was conducted in 25 tertiary neonatal intensive care unit (NICU) in 19 provinces and major cities of China. All infants with gestational age less than 34 weeks, birth weight less than 1 500 g and admission within the first seven days of life from May 2015 to April 2016 were enrolled. Clinical information of those enrolled infants was extracted from the standardized database. Descriptive statistical analysis was used.
Results:A total of 2 956 VLBWI were enrolled with 446 (15.1%) extremely low birth weight infants (ELBWI). Overall, 22.6% (668/2 956) infants were brought home by their parents against medical advice. Among those stayed in the hospital, the in-hospital mortality of VLBWI was 8.0% (182/2 288), and that of ELBWI was 27.3% (83/304). The in-hospital mortality of infants with birth weight between 1 000 and 1 499 g was 5.0% (99/1 984). The estimated overall mortality, was 23.9% (705/2 956) and 47.5% (212/446) for ELBWI. Incidences of sepsis, bronchopulmonary dysplasia, intraventricular hemorrhage (gradeⅢ or above) or periventricular leucomalacia, necrotizing enterocolitis (stageⅡ or above) and retinopathy of prematurity (stageⅢor above) were 23.9% (707/2 956), 18.9% (432/2 288), 11.5% (283/2 469), 5.6% (144/2 561) and 3.4% (61/1 795) in VLBWI, respectively, and 28.9% (129/446), 49.0% (149/304), 21.6% (68/315), 7.2% (23/318) and 13.9% (29/208) in ELBWI. Among infants who received active care, 45.9% (1 050/2 288) died or had at least one major preterm disease during hospitalization, and that of ELBWI was 76.0% (231/304).
Conclusion:The mortality and incidences of major preterm diseases are significantly high among VLBWI in NICU. Further investigations on current practices and quality improvement are needed to improve the overall outcome of VLBWI.
