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Analysis of In-hospital Neonatal Death in the Tertiary Neonatal Intensive Care Unit in China： A Multicenter Retrospective Study

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Chinese Medical Journal 2016年第22期129卷 2652-2658页

作者： Chen-Hong Wang Li-Zhong Du Xiao-Lu Ma Li-Ping Shi Xiao-Mei Tong Hong Liu Guo-Fang Ding Bin Yi Xin-Nian Pan Dan-Ni Zhong Ling Liu Mei Li Cui-Qing Li Shi-Wen Xia Hong-Yun Wang Ling He Kun Liang Xiao-Yu Zhou Shu-Ping Han Qin Lyu Yin-Ping Qiu Ruo-Bing Shan De-Zhi Mu Xiao-Hong Liu Si-Qi Zhuang Jing Guo Li Liu Jia-Jun Zhu Hong Xiong Department of Neonatal Intensive Care Unit Children's Hospital Zhejiang University School of Medicine Hangzhou Zhejiang 310051 China Department of pediatrics Peking University Third Hospital Beijing 100191 China Department of Neonatology Beijing Children's Hospital Capital Medical University Beijing 100045 China Department of pediatrics Peking Union Medical College Hospital Chinese Academy of Medical Sciences Beijing 100730 China Department of Neonatology Gansu Provincial Maternity and Children-care Hospital Lanzhou Gansu 730050 China Department of Neonatology Guangxi Maternal and Child Health Hospital Nanning Guangxi 530003 China Department of Neonatology The First Affiliated Hospital of Guangxi Medical University Nanning Guangxi 530021 China Department of Neonatology Guiyang Maternal and Child Health Care Hospital Guiyang Guizhou 550003 China Department of Neonatology Harbin Children's Hospital Harbin Heilongjiang 150010 China Department of Neonatology Children's Hospital of Hebei Province Shijiazhuang Hebei 050031 China Department of Neonatology Hubei Maternity and Child Heath Hospital Wuhan Hubei 430070 China Department of Neonatal Intensive Care Unit Inner Mongolia Maternal and Child Health Hospital Huhhot Inner Mongolia 010030 China Department of Neonatology Jiangxi Provincial Children's Hospital Nanchang Jiangxi 330006 China Department of pediatric First Affiliated Hospital of Kunming Medical University Kunming Yunnan 650032 China Department of Neonatology Nanjing Children's Hospital of Nanjing Medical University Nanjing Jiangsu 320100 China Department of Neonatology Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University Nanjing Jiangsu 210004 China DeDartment of Neonatal Intensive Care Unit Ningbo Women and Children's Hospital Ningbo Zhejiang 315012 China Department of Neonatology General Hospital of Ningxia Medical University Yinchuan Ningxia 750004 China Department of Neonatology Qingdao Women and

Background：Globally,the proportion of child deaths that occur in the neonatal period remains a high level of 37-41%.Differences of cause in neonate death exist in different regions as well as in different economic development *** specific aim of this study was to investigate the causes,characteristics,and differences of death in neonates during hospitalization in the tertiary Neonatal Intensive Care Unit （NICU） of ***：All the dead neonates admitted to 26 NICUs were included between January 1,2011,and December 31,*** the data were collected retrospectively from clinical records by a designed *** collected from each NICU were delivered to the leading institution where the results were ***：A total of 744 newborns died during the l-year survey,accounting for 1.2% of all the neonates admitted to 26 NICUs and 37.6% of all the deaths in children under 5 years of age in these *** neonate death accounted for 59.3% of all the *** leading causes of death in preterm and term infants were pulmonary disease and infection,*** early neonate period,pulmonary diseases （56.5%） occupied the largest proportion ofpreterm deaths while infection （27%） and neurologic diseases （22%） were the two main causes of term *** late neonate period,infection was the leading cause of both preterm and term neonate *** two-thirds of neonate death occurred after medical care *** the cases who might survive if receiving continuing treatment,parents＇ concern about the long-term outcomes was the main reason of medical care ***：Neonate death still accounts for a high proportion of all the deaths in children under 5 years of *** study showed the majority of neonate death occurred in preterm *** of death varied with the age of death and gestational *** and prompt evaluation of the long-term outcomes should be carried out to guide the critical decision.

关键词： Cause-of-death Mortality Newbom Retrospective Survey

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Mortality and Morbidity of Extremely Low Birth Weight Infants in the Mainland of China： A Multi-center Study

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Chinese Medical Journal 2015年第20期128卷 2743-2750页

作者： Hui-Jia Lin Li-Zhong Du Xiao-Lu Ma Li-Ping Shi Jia-Hua Pan Xiao-Mei Tong Qiu-Ping Li Jian-Guo Zhou Bing Yi Ling Liu Yun-Bing Chen Qiu-Fen Wei Hui-Qing Wu Mei Li Cui-Qing Li Xi-Rong Gao Shi-Wen Xia Wen-Bin Li Chao-Ying Ya Ling He Kun Liang Xiao-Yu Zhou Shu-Ping Han Qin Lyu Yin-Ping Qiu Wen Li Dong-Mei Chen Hong-Ru Lu Xiao-Hong Liu Hong Liu Zhen-Lang Lin Li Liu Jia-Jun Zhu Hong Xiong Shao-Jie Yue Si-Qi Zhuang Department of Neonatal Intensive Care Unit Children's Hospital of Zhejiang University School of Medicine Hangzhou Zhejiang 310053 China Department of Neonatology Anhui Provincial Hospital Hefei Anhui 230001 China Department of pediatrics Peking University Third Hospital Beijing 100191 China Department of Neonatology BaYi Children's Hospital of the General Military Hospital of Beijing People's Liberation Army Beijing 100000 China Department of Neonatology Children's Hospital of Fudan University Shanghai 200032 China Department of Neonatology Gansu Provincial Maternity and Children-care Hospital Lanzhou Gansu 730050 China Department of Neonatotogy Guiyang Maternal and Child Health Care Hospital Guiyang Guizhou 550003 China Department of Neonatology Women and Children Hospital of Guangdong Province Guangzhou Guangdong 510010 China Department of Neonatology Guangxi Maternal and Child Health Hospital Nanning Guangxi 530003 China Department of Neonatology The Third Affiliated Hospital of Guangzhou Medical University Guangzhou Guangdong 510150 China Department of Neonatology Harbin Children's Hospital Harbin Heilongjiang 150010 China Department of Neonatology Children's Hospital of Hebei Province Shijiazhuang Hebei 050031 China Department of Neonatology Hunan Children's Hospital Changsha Hunan 410007 China Department of Neonatology Hubei Maternity and Child Heath Hospital Wuhan Hubei 430070 China Department of pediatrics Tongji Hospital Affiliated to Tongji Medical College Huazhong University of Science and Technology Wuhan Hubei 430030 China Department of Neonatology The First Hospital of Jilin University Changchun Jilin 130021 China Department of Neonatology Jiangxi Provincial Children's Hospital Nanchang Jiangxi 330006 China Department of pediatric First Affiliated Hospital of Kunming Medical University Kunming Yunnan 650032 China Department of Neonatotogy Nanjing Children's Hospital of Nanjing Medical University Nanjing Jiangsu 320100 China De

Background： With the progress ofperinatal medicine and neonatal technology, more and more extremely low birth weight （ELBW） survived all over the world. This study was designed to investigate the short-term ontcomes of ELBW infants during their Neonatal Intensive Care Unit （NICU） stay in the mainland of China. Methods： All infants admitted to 26 NICUs with a birth weight （BW）〈1000 g were included between January 1,2011 and December 31,2011. All the data were collected retrospectively from clinical records by a prospectively designed questionnaire. The data collected from each NICU transmitted to the main institution where the results were aggregated and analyzed. Categorical variables were performed with Pearson Chi-square test. Binary Logistic regression analysis was used to detect risk factors. Results： A total of 258 ELBW infants were admitted to 26 NICUs, of whom the mean gestational age （GA） was 28.1 ± 2.2 weeks, and the mean BW was 868 ± 97 g. The overall survival rate at discharge was 50.0%. Despite aggressive treatment 60 infants （23.3%） died and another 69 infants （26.7%） died after medical care withdrawal. Furthermore, the survival rate was significantly higher in coastal areas than inland areas （53.6% vs. 35.3%, P = 0.019）. BW 〈750 g and GA 〈28 weeks were the largest risk factors, and being small for gestational age was a protective factor related to mortality. Respiratory distress syndrome was the most common complication. The incidence of patent ductus arteriosus, intraventricular hemorrhage, periventricular leukomalacia, bronchopulmonary dysplasia, retinopathy of prematurity was 26.2%, 33.7%, 6.7%, 48.1%, and 41.4%, respectively. Ventilator associated pneumonia was the most common hospital acquired infection during hospitalization. Conclusions： Our study was the first survey that revealed the present status of ELBW infants in the mainland of China. The mortality and morbidity of ELBW infants remained high as compared to other developed countries.

关键词： Extremely Low Birth Weight Infant Mortality National Survey

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