ABSTRACT
OBJECTIVES@#To study the survival rate and the incidence of complications of very preterm infants and the factors influencing the survival rate and the incidence of complications.@*METHODS@#The medical data of the very preterm infants with a gestational age of <32 weeks and who were admitted to the Department of Neonatology in 11 hospitals of Jiangsu Province in China from January 2018 to December 2019 were retrospectively reviewed. Their survival rate and the incidence of serious complications were analyzed. A multivariate logistic regression analysis was used to evaluate the risk factors for death and serious complications in very preterm infants.@*RESULTS@#A total of 2 339 very preterm infants were enrolled, among whom 2 010 (85.93%) survived and 1 507 (64.43%) survived without serious complications. The groups with a gestational age of 22-25@*CONCLUSIONS@#The survival rate is closely associated with gestational age in very preterm infants. A low 1-minute Apgar score (≤3) may increase the risk of death in very preterm infants, while high gestational age, high birth weight, and prenatal use of glucocorticoids are associated with the reduced risk of death. A low 5-minute Apgar score (≤3) and maternal chorioamnionitis may increase the risk of serious complications in these infants, while high gestational age and high birth weight may reduce the risk of serious complications.
Subject(s)
Female , Humans , Infant, Newborn , Pregnancy , Gestational Age , Infant, Premature , Infant, Premature, Diseases , Infant, Very Low Birth Weight , Retrospective Studies , Survival RateABSTRACT
It is recognized that prenatal care plays an important role in reducing adverse birth.Chinese pregnant women with medical condition were required to seek additional health care based on the recommended at least 5 times health care visits.This study was to estimate the association between prenatal care utilization (PCU) and preterm birth (PTB),and to investigate if medical conditions during pregnancy modified the association.This population-based case control study sampled women with PTB as cases;one control for each case was randomly selected from women with term births.The Electronic Perinatal Health Care Information System (EPHCIS) and a questionnaire were used for data collection.The PCU was measured by a renewed Prenatal Care Utilization (APNCU) index.Logistic regression models were used to estimate odds ratios (OR) and the 95％ confidence interval (95％ CI).Totally,2393 women with PTBs and 4263 women with term births were collected.In this study,695 (10.5％) women experienced inadequate prenatal care,and 5131 (77.1％) received adequate plus prenatal care.Inadequate PCU was associated with PTB (adjusted OR:1.41,95％ CI:1.32-1.84);the similar positive association was found between adequate plus PCU and PTB.Among women with medical conditions,these associations still existed;but among women without medical conditions,the association between inadequate PCU and PTB disappeared.Our data suggests that women receiving inappropriate PCU are at an increased risk of having PTB,but it does depend on whether the woman has a medical condition during pregnancy.
ABSTRACT
BACKGROUND: This study investigates the relationship of socioeconomic status with adverse birth outcomes (low birth weight and preterm birth) and the relationship of socioeconomic status with infant mortality, using the birth cohort in Korea, 1995-2010. METHODS: In Korea, 8,648,035 births from 1995 to 2010 were studied with respect to social variation in adverse birth outcomes and infant mortality. The effect of social inequality was examined against adverse birth outcomes and infant mortality using multivariate logistic regression after controlling for other covariates. RESULTS: Social inequality were observed in adverse birth outcomes: low birth weight (LBW, 1,500-2,499 g), very LBW (1,000-1,499 g), and extremely LBW (500-999 g) as well as moderately preterm birth (PTB, 33-36 weeks), very PTB (28-32 weeks), extremely PTB (22-27 weeks), and infant mortality. The effect of social inequality was higher among moderately LBW (1,500-2,499 g) and PTB (33-36 weeks) than very or extremely LBW and PTB. CONCLUSION: The social inequality in adverse birth outcomes (low birthweight and preterm) and infant mortality existed and increased in Korea from 1995 to 2010. The effect of maternal education on adverse birth outcomes as well as infant mortality was apparent in the study results. Especially, social inequality in infant mortality was greater among the sub-normal births (low birth weight [1,500-2,499 g] or preterm birth [33-36 weeks]), which suggests, social interventions should aim at more among the subnormal births. This study suggest that tackling inequality in births as well as infant mortality should be focused on the social inequality itself.