RESUMO
Objective:To study the effects of gender on clinical outcomes of extremely low birth weight infants (ELBWI) and to analyze the risk factors of mortality.Methods:From January 2011 to December 2020, ELBWI (birth weight <1 000 g) admitted to the Neonatology Department of our hospital were retrospectively studied. The infants were assigned into the male group and the female group. Incidences of major complications, survival rate and mortality rate were compared between the two groups. The infants were also assigned into survival group and death group according to their clinical outcomes. Binary multivariate unconditional Logistic regression was used to analyze the risk factors of mortality in ELBWI.Results:A total of 637 ELBWI cases were included. 311 cases were in the male group with a survival rate of 57.9% (180/311) and 326 cases were in the female group with a survival rate of 57.4% (187/326). The incidences of neonatal respiratory distress syndrome (RDS), bronchopulmonary dysplasia (BPD), pulmonary hemorrhage and severe intraventricular hemorrhage (IVH) in the male group were significantly higher than the female group ( P<0.05). Significant increases of survival rate existed for both groups year by year ( P<0.01).No significant differences existed in survival rate, mortality rate of infants receiving proactive treatment and mortality rate of infants withdrawing treatment between the two groups ( P>0.05). Multivariate unconditional Logistic regression analysis showed that withdrawing treatment ( P<0.01) and pulmonary hemorrhage ( P<0.05) were associated with increased risks of mortality. Conclusions:Male ELBWI have higher risks of RDS, BPD and severe IVH than female ELBWI. Withdrawing treatment and pulmonary hemorrhage are common risk factors of mortality for both male and female ELBWI.
RESUMO
Objective To explore the relationships of insulin-like growth factor 1 (IGF-1) and insulin-like growth factor binding protein 3 (IGFBP-3) with growth of very low birth weight (VLBW) infants in the early postnatal stage. Methods According to the individual gestational age and birth weight, 32 cases of VLBW infants were divided into small for gestational age (SGA) group and appropriate for gestational age (AGA) group. After birth, all the infants were given the same nutritional intake. The body weight, body length, head circumference and body mass index (BMI) were monitored at different time points (d0, d7, d14 and d28 after birth). Serum IGF-1 and IGFBP-3 levels were measured by radiommunoassay, and IGF-1/IGFBP-3 molar ratio was calculated. Results There was no signiifcant difference of body weight, body length, head circumference and BMI between two groups at d0, d7, d14 after birth. Body weight and BMI in SGA group were less than those in AGA group at d28 after birth (P<0.05). The levels of IGF-1, IGFBP-3 and IGF-1/IGFBP-3 in SGA group and IGF-1/IGFBP-3 in AGA group did not change with age after birth. The levels of IGF-1 and IGFBP-3 were increased in AGA group after birth. The level of IGF-1 in AGA group at d14 and d28 after birth was higher than that in AGA group at d0 after birth (P<0.05). The level of IGFBP-3 in AGA group at d28 after birth was higher than that in AGA group at d0 after birth (P<0.05). The levels of IGF-1 and IGFBP-3 in SGA group at d28 after birth were lower than those in AGA group at d28 after birth (P<0.05). Conclusions Serum IGF-1 and IGFBP-3 levels in SGA group are lower than those in AGA group. Low levels of IGF-1 and IGFBP-3 may result in growth retardation.