The Impact of Surgical Intervention on Neurodevelopmental Outcomes in Very Low Birth Weight Infants: a Nationwide Cohort Study in Korea
Journal of Korean Medical Science
; : e271-2019.
Artículo
en Inglés
| WPRIM (Pacífico Occidental)
| ID: wpr-765116
Biblioteca responsable:
WPRO
ABSTRACT
BACKGROUND:
To investigate the incidence of surgical intervention in very low birth weight (VLBW) infants and the impact of surgery on neurodevelopmental outcomes at corrected ages (CAs) of 18–24 months, using data from the Korean Neonatal Network (KNN).METHODS:
Data from 7,885 VLBW infants who were born and registered with the KNN between 2013 to 2016 were analyzed in this study. The incidences of various surgical interventions and related morbidities were analyzed. Long-term neurodevelopmental outcomes at CAs of 18–24 months were compared between infants (born during 2013 to 2015, n = 3,777) with and without surgery.RESULTS:
A total of 1,509 out of 7,885 (19.1%) infants received surgical interventions during neonatal intensive care unit (NICU) hospitalization. Surgical ligation of patent ductus arteriosus (n = 840) was most frequently performed, followed by laser therapy for retinopathy of prematurity and laparotomy due to intestinal perforation. Infants who underwent surgery had higher mortality rates and greater neurodevelopmental impairment than infants who did not undergo surgery (P value < 0.01, both). On multivariate analysis, single or multiple surgeries increased the risk of neurodevelopmental impairment compared to no surgery with adjusted odds ratios (ORs) of 1.6 with 95% confidence interval (CI) of 1.1–2.6 and 2.3 with 95% CI of 1.1–4.9.CONCLUSION:
Approximately one fifth of VLBW infants underwent one or more surgical interventions during NICU hospitalization. The impact of surgical intervention on long-term neurodevelopmental outcomes was sustained over a follow-up of CA 18–24 months. Infants with multiple surgeries had an increased risk of neurodevelopmental impairment compared to infants with single surgeries or no surgeries after adjustment for possible confounders.
Texto completo:
Disponible
Contexto en salud:
ODS3 - Salud y Bienestar
/
ODS3 - Meta 3.4 Reducir las muertes prematuras por enfermedades no transmisibles
/
ODS3 - Meta 3.2 Evitar muertes en recién nacidos y niños menores de 5 años
Problema de salud:
Meta 3.2: Evitar muertes en recién nacidos y niños menores de 5 años
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Enfermedad Cardiovascular
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Anomalías Congénitas y Cromosómicas
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Otras Enfermedades Circulatorias
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Atención de Salud Neonatal
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Enfermedades No Transmisibles
Base de datos:
WPRIM (Pacífico Occidental)
Asunto principal:
Retinopatía de la Prematuridad
/
Cuidado Intensivo Neonatal
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Oportunidad Relativa
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Incidencia
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Análisis Multivariante
/
Estudios de Cohortes
/
Estudios de Seguimiento
/
Mortalidad
/
Recién Nacido de muy Bajo Peso
/
Conducto Arterioso Permeable
Tipo de estudio:
Estudio de etiología
/
Estudio de incidencia
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Estudio observacional
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Estudio pronóstico
/
Factores de riesgo
Límite:
Humanos
/
Lactante
/
Recién nacido
País/Región como asunto:
Asia
Idioma:
Inglés
Revista:
Journal of Korean Medical Science
Año:
2019
Tipo del documento:
Artículo