Abstract
Objective: Our aim was to assess the association of perinatal factors with the early neonatal mortality in newborns with very low (VLBW) and extremely low birth weight (ELBW). Methods: The statistical data was carried out, that is analysis of 17 perinatal factors of 28 newborns with an ELBW with gestation of 23–27 weeks and 18 newborns with a VLBW with gestation of 28–32 weeks, who died in the first 7 days of life. The comparison group consisted of 25 newborns with an ELBW and 56 children with a VLBW with gestation of 25–27 and 28–32 weeks, respectively, who survived the early neonatal period. The association of risk factors with the early neonatal mortality was assessed by means of a multiple-factor logistic regression analysis. A critical p error level was set equal to 0.05. Results: In newborns with a VLBW the increased risk of the early neonatal mortality depended on a gestation term (OR 4.40, 95% CI 1.56–11.71; р = 0.002) and emergency Caesarean section (OR 7.48, 95% CI 1.28–43.74; р = 0.008). A vaginal birth increased the survival chance (OR 0.12, 95% CI 0.01–0.86; р = 0.032). Newborns with an ELBW had the following factors of the increased risk of the early neonatal mortality: gestational age (OR 2.86, 95% CI 1.06–7.73; р = 0.038), Apgar score at the 5th minute (OR 1.91, 95% CI 0.99–3.69; р = 0.050) and presence of chorioamnionitis (OR 5.45, 95% CI 1.0–29.53; p = 0.048). An elective Caesarean section increased the survival chance (OR 0.02, 95% CI 0.001–0.44; p = 0.048). Conclusion: Summarizing the obtained data, we can conclude that besides a gestational age the risk of early neonatal mortality in newborns with a VLBW may be increased due to the emergency Caesarean section, with an ELBW — due to a low Apgar score at the 5th minute and the presence of mother's chorioamnionitis. A vaginal birth in newborns with a VLBW and an elective Caesarean section in children with an ELBW increase survival chances.
Highlights
Цель исследования: оценить связь перинатальных факторов с ранней неонатальной смертностью у новорожденных с очень низкой (ОНМТ) и экстремально низкой массой тела (ЭНМТ)
Our aim was to assess the association of perinatal factors with the early neonatal mortality in newborns with very low (VLBW) and extremely low birth weight (ELBW)
In newborns with a VLBW the increased risk of the early neonatal mortality depended on a gestation term and emergency Caesarean section
Summary
Цель исследования: оценить связь перинатальных факторов с ранней неонатальной смертностью у новорожденных с очень низкой (ОНМТ) и экстремально низкой массой тела (ЭНМТ). Результаты: у новорожденных с ОНМТ повышенный риск ранней неонатальной смертности был связан со сроком гестации (ОШ 4,40, 95% ДИ 1,56–11,71; р = 0,002) и экстренной операцией кесарева сечения (ОКС) У новорожденных с ЭНМТ факторами повышенного риска ранней неонатальной смертности стали гестационный возраст (ОШ 2,86, 95% ДИ 1,06–7,73; р = 0,038), оценка по шкале Апгар на 5-й мин Можно сделать вывод, что помимо гестационного возраста риск ранней неонатальной смертности у новорожденных с ОНМТ увеличивает экстренная ОКС, с ЭНМТ — низкая оценка по шкале Апгар на 5-й мин и наличие хориоамнионита у матери. Вагинальные роды у новорожденных с ОНМТ и плановая ОКС у детей с ЭНМТ повышают шансы на выживание. Ключевые слова: новорожденные, смертность, факторы риска, очень низкая масса тела, экстремально низкая масса тела
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