不同胎龄和出生体重的早产儿死亡情况分析

Analysis of premature death related to different gestational age and birth weight

目的分析不同胎龄和出生体重的早产儿的死亡情况,以了解胎龄、出生体重对早产儿病死率的影响。方法收集2007年1月1日—2008年12月31日在同济大学附属上海市第一妇婴保健院出生的早产儿1453例,依据不同胎龄、出生体重统计其病死率,并对死亡原因进行分析。结果1453例早产儿中,死亡47例,病死率为3.23%。胎龄<32周早产儿的胎龄越小病死率越高(P值均<0.05),胎龄≥32周早产儿的病死率与胎龄无关联(P>0.05)。胎龄<32周早产儿的死亡原因前3位分别为新生儿呼吸窘迫综合征(8例)、新生儿窒息(5例)、新生儿感染(3例);胎龄32～36+6周早产儿死亡原因前2位分别为先天畸形(3例)、新生儿感染(2例)。结论胎龄32周、体重达1500g可能是胎儿发育的一个界点,应加强围产期保健。

Objective To analyze the premature death rates of different gestational ages and birth weights, so as to provide evidence for lowering the premature death rate. Methods The clinical information of all premature infant birthed in Shanghai First Maternity and Infant Hospital from 2007 to 2008 were collected. And the death rates of the infants according to different gestational ages and birth weights were calculated, and the causes of death were analyzed. Results There were 47 death cases among the 1,453 premature infants, with a death rate of 3.23%. When the gestational age of premature was less than 32 weeks, higher death rate was found in those with shorter gestational age （P 0.05）. The death rate of infants with longer than 32 weeks was not related to the gestational age （P0.05）. For infants with less than 32 weeks of gestational age, the top three causes of death were neonatal respiratory distress syndrome （8 cases）, asphyxia of newborn （5 cases）, and neonatal infection （3 cases）. The top two causes of premature death for those with a gestational age of 32-36＋6 weeks were congenital malformation （3 cases） and neonatal infection （2 cases）. Conclusion The gestational age of 32 weeks and weight of 1 500 g might be a very important occasion for neonatal development, and peri-natal health care should be strengthened during that period.