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Developmental outcome of very low birth weight infants in a developing country

机译:发展中国家极低出生体重婴儿的发育结局

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Background Advances in neonatal care allow survival of extremely premature infants, who are at risk of handicap. Neurodevelopmental follow up of these infants is an essential part of ongoing evaluation of neonatal care. The neonatal care in resource limited developing countries is very different to that in first world settings. Follow up data from developing countries is essential; it is not appropriate to extrapolate data from units in developed countries. This study provides follow up data on a population of very low birth weight (VLBW) infants in Johannesburg, South Africa. Methods The study sample included all VLBW infants born between 01/06/2006 and 28/02/2007 and discharged from the neonatal unit at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). Bayley Scales of Infant and Toddler Development Version 111 (BSID) 111 were done to assess development. Regression analysis was done to determine factors associated with poor outcome. Results 178 infants were discharged, 26 were not available for follow up, 9 of the remaining 152 (5.9%) died before an assessment was done; 106 of the remaining 143 (74.1%) had a BSID 111 assessment. These 106 patients form the study sample; mean birth weight and mean gestational age was 1182 grams (SD: 197.78) and 30.81 weeks (SD: 2.67) respectively. The BSID (111) was done at a median age of 16.48 months. The mean cognitive subscale was 88.6 (95% CI: 85.69 - 91.59), 9 (8.5%) were Conclusion Although the neurodevelopmental outcome of this group of VLBW infants was within the normal range, with a low incidence of cerebral palsy, these results may reflect the low survival of babies with a birth weight below 900 grams. In addition, mean subscale scores were low and one third of the babies were identified as "at risk", indicating that this group of babies warrants long-term follow up into school going age.
机译:背景技术新生儿护理方面的进展使处于残障风险的极早婴儿得以生存。这些婴儿的神经发育跟进是正在进行的新生儿护理评估的重要组成部分。资源有限的发展中国家的新生儿保健与第一世界的环境大不相同。来自发展中国家的后续数据至关重要;从发达国家的单位推断数据是不合适的。这项研究提供了南非约翰内斯堡极低出生体重(VLBW)婴儿群体的随访数据。方法该研究样本包括2006年1月6日至2007年2月28日之间出生并从夏洛特·马克西·约翰内斯堡学术医院(CMJAH)的新生儿科出院的所有VLBW婴儿。进行了Bayley婴幼儿发展量表111(BSID)111量表的评估。进行回归分析以确定与不良预后相关的因素。结果178例婴儿出院,无法随访26例,其余152例中有9例(5.9%)在评估前死亡。其余143个中有106个(74.1%)进行了BSID 111评估。这106位患者构成了研究样本;平均出生体重和平均胎龄分别为1182克(SD:197.78)和30.81周(SD:2.67)。 BSID(111)的年龄中位数为16.48个月。结论认知平均量表为88.6(95%CI:85.69-91.59),其中9(8.5%)为结论。尽管该组VLBW婴儿的神经发育结局处于正常范围,脑瘫发生率较低,但这些结果可能反映出出生体重低于900克的婴儿存活率低。此外,平均分量表得分较低,三分之一的婴儿被确定为“有风险”,这表明该组婴儿需要长期随访入学年龄。

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