Hong Fei,Zhang Min,Han Shuping,et al.Analysis of risk factors for progression of periventricular-intraventricular hemorrhage in preterm infants with gestational age ＜ 32 weeks[J].Journal of Clinical Pediatric Surgery,,():745-751.[doi:10.3760/cma.j.cn101785-202406010-008]
Analysis of risk factors for progression of periventricular-intraventricular hemorrhage in preterm infants with gestational age ＜ 32 weeks
- Abstract:
- Objective To investigate potential risk factors for the progression of periventricular-intraventricular hemorrhage (PIVH) in preterm infants with gestational age <32 weeks. Methods A retrospective study was conducted on clinical data from infants with gestational age <32 weeks admitted to the neonatal intensive care units (NICUs) of 20 hospitals in the Jiangsu Neonatal Perinatal Cooperative Network between January 1,2020 and December 31,2022.Infants were included if their first cranial ultrasound within 3 days after birth indicated grade Ⅰ-Ⅱ PIVH,followed by a second ultrasound within 10 days.Infants with congenital malformations,genetic abnormalities,or incomplete data were excluded.Multivariate logistic regression was used to identify independent risk factors for early PIVH progression. Results Among 3,347 preterm infants,551 were <32 weeks gestational age.Of these,29 infants progressed from grade Ⅰ/Ⅱ to grade Ⅲ/Ⅳ PIVH (progression group),while 522 did not (non-progressive group).Univariate logistic regression identified several associated factors:gestational age,multiple birth status,1-minute Apgar score,maternal temperature >38℃ before delivery,neonatal critical illness score,Score for Neonatal Acute Physiology-Ⅱ (SNAP-Ⅱ),Score for Neonatal Acute Physiology Perinatal Extension-Ⅱ (SNAPPE-Ⅱ),early-onset sepsis,birth asphyxia,neonatal pulmonary hypertension,shock,anemia of prematurity,thrombocytopenia,invasive mechanical ventilation,surfactant administration,platelet and plasma transfusions.Multivariate logistic regression indicated that gestational age <28 weeks (OR=6.346,95%CI:2.914-13.824,P<0.05) and maternal temperature >38℃ before delivery (OR=2.454,95%CI:1.153-5.225,P<0.05) were independent risk factors for early PIVH progression. Conclusions For preterm infants with gestational age <32 weeks,gestational age <28 weeks and maternal temperature >38℃ before delivery are significant risk factors for early progression of PIVH.
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Memo
收稿日期:2024-6-5。
基金项目:南京市卫生科技发展专项资金(YKK21160,YKK22149);南通市民生科技计划项目专项资金(MS22022026);南通市卫健委科研课题(MSZ2023013,QNZ2023030)
通讯作者:韩树萍,Email:shupinghan@njmu.edu.cn