Abstract Objective To investigate the factors contributing to the withdrawal from treatment in neonates with respiratory failure. Methods The medical data of 2 525 neonates with respiratory failure were retrospectively studied, who were reported in 30 hospitals of Jiangsu Province from January to December, 2019. According to whether a complete treatment was given, they were divided into a complete treatment group with 2 162 neonates and a withdrawal group with 363 neonates. A multivariate logistic regression analysis was used to investigate the factors contributing to the withdrawal from treatment in neonates with respiratory failure. Results The multivariate logistic regression analysis showed that small-for-gestational-age birth, congenital abnormality, gestational age < 28 weeks, living in the rural area or county-level city, and maternal age < 25 years were risk factors for the withdrawal from treatment in neonates with respiratory failure (P < 0.05), while a higher 5-minute Apgar score and cesarean section were protective factors (P < 0.05). Furthermore, 176 answers were obtained from 160 parents of the neonates who were willing to tell the reason for the withdrawal from treatment, among which severe sequelae (44.9%, 79/176) had the highest frequency, followed by uncontrollable disease condition (24.4%, 43/176), family financial difficulties (18.2%, 32/176), and dependence on mechanical ventilation (12.5%, 22/176). Conclusions Small-for-gestational-age birth, congenital abnormality, gestational age, living area, maternal age, Apgar score at birth, and method of birth are contributing factors for the withdrawal from treatment in neonates with respiratory failure. A poor prognosis and a low quality of life in future might be major immediate causes of withdrawal from treatment in neonates with respiratory failure, which needs to be confirmed by further studies.
HANG Fei-Fei,LU Ke-Yu,WU Xin-Ping et al. Contributing factors for the withdrawal from treatment in neonates with respiratory failure[J]. CJCP, 2021, 23(6): 588-592.
HANG Fei-Fei,LU Ke-Yu,WU Xin-Ping et al. Contributing factors for the withdrawal from treatment in neonates with respiratory failure[J]. CJCP, 2021, 23(6): 588-592.
Lakshminrusimha S, Saugstad OD. The fetal circulation, pathophysiology of hypoxemic respiratory failure and pulmonary hypertension in neonates, and the role of oxygen therapy[J]. J Perinatol, 2016, 36(Suppl 2):S3-S11. DOI:10.1038/jp.2016.43. PMID:27225963.
[3]
Sakonidou S, Dhaliwal J. The management of neonatal respiratory distress syndrome in preterm infants (European Consensus Guidelines - 2013 update)[J]. Arch Dis Child Educ Pract Ed, 2015, 100(5):257-259. DOI:10.1136/archdischild-2014-306642. PMID:25694422.
[4]
Ma L, Liu CQ, Wang YQ, et al. Mortality of neonatal respiratory failure related to socioeconomic factors in Hebei province of China[J]. Neonatology, 2011, 100(1):14-22. DOI:10.1159/000320155. PMID:21150226.
Wang HH, Gao XR, Liu CQ, et al. Morbidity and mortality of neonatal respiratory failure in China:surfactant treatment in very immature infants[J]. Pediatrics, 2012, 129(3):e731-e740. DOI:10.1542/peds.2011-0725. PMID:22331337.
Zaigham M, Karel M. Apgar score in premature infants associated with neonatal death prediction[J]. J Pediatr, 2020, 226:309-313. DOI:10.1016/j.jpeds.2020.08.055.
