超早产儿生后72 h内低血压发生的危险因素及预后分析

doi:10.7499/j.issn.1008-8830.2304027

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Abstract Objective To investigate the risk factors and prognosis of hypotension within 72 hours after birth in extremely preterm infants. Methods A retrospective analysis was conducted on clinical data of extremely preterm infants admitted to the Children's Hospital of Zhejiang University School of Medicine from January 2019 to April 2022. Based on the presence of hypotension within 72 hours after birth, the eligible infants were divided into a hypotension group (41 cases) and a normotension group (82 cases). The clinical characteristics, echocardiographic parameters within 72 hours after birth, and early complications were compared between the two groups. Multivariate logistic regression analysis was used to explore the risk factors for hypotension within 72 hours after birth, and receiver operating characteristic curve analysis was performed to evaluate the predictive value of relevant indicators for the occurrence of hypotension within 72 hours after birth in the preterm infants. Results The proportion of infants who required medication or surgical closure of patent ductus arteriosus (PDA), the proportions of infants with intraventricular hemorrhage ≥ grade III and severe pulmonary hemorrhage, and the mortality rate within 7 days in the hypotension group were significantly higher than those in the normotension group (P<0.05). Multivariate logistic regression analysis showed that lower birth weight, larger PDA diameter, and hemodynamically significant PDA were risk factors for the occurrence of hypotension within 72 hours after birth in extremely preterm infants (P<0.05). The receiver operating characteristic curve analysis showed that the combination of birth weight, PDA diameter, and hemodynamically significant PDA had an area under the curve of 0.873 (95%CI: 0.802-0.944, P<0.05) for predicting hypotension within 72 hours after birth, with a sensitivity of 73.2% and specificity of 91.5%. Conclusions Hypotension within 72 hours after birth is closely related to birth weight and PDA, and increases the risk of early severe complications and mortality in extremely preterm infants.

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	LIU Tai-Xiang
	SHI Li-Ping

Key words： Hypotension Patent ductus arteriosus Intraventricular hemorrhage Pulmonary hemorrhage Extremely preterm infant

Received: 07 April 2023

Cite this article:

LIU Tai-Xiang,SHI Li-Ping. Risk factors and prognosis of hypotension within 72 hours after birth in extremely preterm infants[J]. CJCP, 2023, 25(10): 1001-1007.

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http://www.zgddek.com/EN/10.7499/j.issn.1008-8830.2304027 OR http://www.zgddek.com/EN/Y2023/V25/I10/1001

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