Retrospective analysis on the hospitalization, outcomes and follow-up results of extremely low birth weight infants

Abstract

Objective To investigate the hospitalization, outcomes and follow-up results of extremely low birth weight infants (ELBWI). Methods From 1 January 2010 to 1 February 2015, a total of 129 cases of ELBWI in Neonatal Intensive Care Unit (NICU) of Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital were selected as research subjects. A retrospective analysis was conducted to collect their medical records and follow-up data and to analyze their mothers′ general clinical data, main clinical symptoms and complications in neonatal period, the outcomes and follow-up conditions after discharge from hospital. The respiratory therapy conditions between ELBWI with gestational age <28 weeks and ≥28-32 weeks were compared statistically. Results ①Among the 129 cases of ELBWI, the top three pregnancy complications of mothers of ELBWI were gestational hypertension diseases (69.0%, 89/129), premature rupture of membrane (37.2%, 48/129) and gestational diabetes mellitus (16.3%, 21/129), respectively. ②Among the 129 cases of ELBWI, the top five clinical symptoms in neonatal period were dyspnea (96.7%, 126/129), jaundice (85.3%, 110/129), poor response (77.5%, 100/129), abdominal distention (75.2%, 97/129), and body cyanosis (52.7%, 68/129), respectively. ③Among the 129 cases of ELBWI, the top six complications in neonatal period were hyperbilirubinemia (85.3%, 110/129), anemia of prematurity (82.9%, 107/129), nosocomial infection (81.4%, 105/129), respiratory distress syndrome (RDS)(64.3%, 83/129), bronchopulmonary dysplasia(BPD) (50.4%, 65/129) and feeding intolerance (50.4%, 65/129), respectively. ④Among the ELBWI who were alive and discharged from hospital, the usage rate and time of respirator assisted ventilation, the usage rate of continuous positive airway pressure (CPAP) in ELBWI with gestational age <28 weeks all were higher or longer than those in ELBWI with gestational age ≥28-32 weeks, and all the differences were statistically significant (χ2=11.733, Z=-4.963, χ2=11.309; P<0.001). But there was no statistical difference between them in the usage time of CPAP (Z=-1.550, P=0.121). ⑤Among the 129 cases of ELBWI, 98 cases were cured and discharged from hospital, 1 case was referred to another hospital for laser treatment due to ROP, 30 cases died as ineffective treatment or give-up treatment. The follow-up results of 99 alive and discharged cases showed that 11 cases failed to follow up and the rate was 11.1%(11/99), 88 cases were followed up successfully. And among the 99 cases, 53.5% (53/99) failed the auditory brainstem response audiometry test, 42.4% (42/99) cases were combined with ROP. Among the 88 cases who were followed up successfully, rates of motor and language development retardation were 12.5% (11/88) and 4.5% (4/88), respectively, and only 36.4% (32/88) received Gesell Developmental Scale assessment or follow-up in rehabilitation department regularly. Conclusions Gestational hypertension diseases and premature rupture of membrane are the common causes of ELBWI. And there are many complications in neonatal period of ELBWI, so we should take close follow-up after they discharge from hospitals. Key words: Hospitalization; Outcomes; Retrospective studies; Infant, extremely low birth weight