Abstract OBJECTIVE: To describe the clinical features, treatments and prognosis of very low birth weight infants (VLBWIs) requring mechanical ventilation, to assess the risk factors associated with the mortality of VLBWIs, and to evaluate the significance of the scoring system based on clinical risk index for babies (CRIB) and the score for neonatal acute physiology-perinatal extension II (SNAPPE-II) for predicting mortality risk for premature infants in China. METHODS: Perinatal data were collected from 127 VLBWIs requring mechanical ventilation who were admitted to the neonatal intensive care unit (NICU) from January 2010 to October 2011. RESULTS: The enrolled infants had a mean gestational age of 31±2 weeks, a mean birth weight of 1290±170 g, a male/female ratio of 1.23∶1, and extremely low birth weight infant accounting for 6.3%. Of the 127 cases, 48.0% were administered with pulmonary surfactant (PS), and 49.6% received endotracheal intubation ventilation. The overall in-hospital mortality was 41.7%. Multivariate logistic regression revealed the following independent risk factors for mortality: low birth weight, multiple birth, cesarean section, and low PaO2/FiO2 ratio (OR = 1.611, 7.572, 4.062, and 0.133 respectively; P<0.05). SNAPPE-II and CRIB showed good performance in predicting prognosis, with areas under the ROC curve of 0.806 and 0.777 respectively. CONCLUSIONS: The overall mortality rate of VLBWIs is still relatively high. The high-risk factors for VLBWI mortality include low birth weight, multiple birth, cesarean section, and low PaO2/FiO2 ratio. The neonatal illness severity scoring system (using SNAPPE-II and CRIB) can be used to quantify illness severity in premature infants.
MA Li,LIU Cui-Qing,MENG Ling-Zhi et al. Prospective study on in-hospital mortality and its risk factors in very low birth weight infants requring mechanical ventilation[J]. 中国当代儿科杂志, 2012, 14(10): 737-741.
MA Li,LIU Cui-Qing,MENG Ling-Zhi et al. Prospective study on in-hospital mortality and its risk factors in very low birth weight infants requring mechanical ventilation[J]. CJCP, 2012, 14(10): 737-741.
［1］Zeitlin J, Draper ES, Kollée L, Milligan D, Boerch K, Agostino R, et al. Differences in rates and short-term outcome of live births before 32 weeks of gestation in Europe in 2003: results from the MOSAIC cohort［J］. Pediatrics, 2008,121(4):e936-e944.
［2］Horbar JD, Badger GJ, Carpenter JH, Fanaroff AA, Kilpatrick S, LaCorte M, et al. Trends in mortality and morbidity for very low birth weight infants, 1991-1999［J］. Pediatrics, 2002,110(1 Pt 1): 143-151.
［3］Qian L, Liu C, Zhuang W, Guo Y, Yu J, Chen H, et al. Neonatal respiratory failure: a 12-month clinical epidemiologic study from 2004 to 2005 in China［J］. Pediatrics, 2008,121(5): e1115-e1124.
［4］Ma L, Liu C, Wang Y, Li S, Zhai S, Gu X, et al. Mortality of neonatal respiratory failure related to socioeconomic factors in Hebei province of China［J］. Neonatology, 2011, 100(1): 14-22.
［5］Wang HH, Gao X, Liu C, Yan C, Lin X, Yang C, et al. Morbidity and mortality of neonatal respiratory failure in China: surfactant treatment in very immature infants［J］. Pediatrics, 2012, 129(3): e731-e740.
［6］Dorling JS, Field DJ, Manktelow B. Neonatal disease severity scoring systems［J］. Arch Dis Child Fetal Neonatal Ed, 2005, 90(1): F11-F16.
［7］Zupancic JA, Richardson DK, Horbar JD, Carpenter JH, Lee SK, Escobar GJ, et al. Revalidation of the score for neonatal acute physiology in the vermont Oxford network［J］. Pediatrics, 2007, 119(1): e156-e163.
［11］Angus DC, Linde-Zwirble WT, Clermont G, Griffin MF, Clark RH. Epidemiology of neonatal respiratory failure in the United States: projections from California and New York［J］. Am J Respir Crit Care Med, 2001, 164(7): 1154-1160.
［12］Corchia C, Orzalesi M. Geographic variations in outcome of very low birth weight infants in Italy［J］. Acta Pediatrica, 2007, 96(1): 35-38.
［13］Gagliardi L, Cavazza A, Brunelli A, Battaglioli M, Merazzi D, Tandoi F, et al. Assessing mortality risk in very low birthweight infants: a comparison of CRIB, CRIB-II, and SNAPPEII［J］. Arch Dis Child Fetal Neonatal Ed, 2004, 89(5): F419-F422.
