Incidence and outcome of major perinatal comorbidities of all hospitalized neonates requiring intensive and critical care: a livebirth population-based survey.
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Zhang Xiaoxue, Zhai Shufen, Zhao Zhimin, Li Liujun, Qiao Baojun, Wen Zhijie, Li Jinxia, Wang Meifang, Wei Peng, Xu Yaling, Guo Xiaojing, Sun Bo, Handan Neonatal Collaborative Study Group, Ma Limin, Wang Hongxin, Zhao Xiaoling, Wang Zhihong, Li Xueliang, Du Suying, Wang Xianjie, Shi Shuying, Dong Yongshuang, Zhang Hongchao, Fang Pingchang, Yue Ming, Guo Yunze, Zhang Shuli, Zhang Jianying, Han Heai, Li Qiaoling, Wang Bingchen, Feng Shuyi, Yang Yun, Ning Hongwei, Dong Libin, Liu Tao, Wen Zhaohua, He Xingyu, Zhao Zhengang, Guo Jing, Wang Yan, Ma Yanling, Li Jianying, He Xiaojuan, Yin Yuhua, Gao Jingli, Jia Xiaoyun, Miao Xinguo
Аннотация
SUBJECTS AND METHODS: We prospectively collected a datafile consisting of 10,840 (13.72%) cases as all hospitalized neonates from 79,012 livebirths in Handan in 2020, a sub-provincial region with 9.41 million population and intermediate-to-high level of socioeconomic development in north China. The diagnoses of diseases requiring intensive and/or critical care, and causes of deaths, were categorized, and perinatal and disease-specific risks of death were estimated by multivariable logistic regression models.
RESULTS: Livebirth-based incidence of major perinatal comorbidities were 19.7‰ for congenital pneumonia/early onset sepsis, 12.1‰ intraventricular hemorrhage, 8.7‰ birth asphyxia, 8.7‰ respiratory distress syndrome (RDS), 7.7‰ sepsis and 6.8‰ congenital anomalies (CA). Case-fatality rate (cause-specific mortality rate referring to livebirths) of major diseases were 47.1% (0.2‰) pulmonary hemorrhage, 26.9% (0.1‰) necrotizing enterocolitis, 15.6% (0.2‰) late onset sepsis, 14.1% (1.2‰) RDS, 11.3% (0.8‰) CA, and 11% (1.0‰) asphyxia. There were 242 (2.2%) died in hospital (3.1‰ of all livebirths), 52.1% being in the preterm, 49.2% in low birthweight, and <40% in those <28 weeks of gestation, or <1000 g birthweight, respectively. Death risks associated with the perinatal and neonatal morbidities were markedly declined with variable magnitudes as estimated by multivariable logistic regression models.
CONCLUSIONS: The incidence rates of major perinatal comorbidities, neonatal mortality rates, and major risks to the overall and specific outcome of all the hospitalized neonates in Handan, denote baseline characteristics and efficiency of the regional perinatal-neonatal care system.