A Comparison of Survival in Extremely Low Birth Weight Infants between Periods 1997-1998 and 1998-2000

超早産兒存活率：兩段時期之比較

林聖興(Sheng-Shing Lin) ； 蘇百弘(Bai-Horng Su) ； 林宗文(Tsung-Wen Lin) ； 林鴻志(Hung-Chih Lin) ； 彭慶添(Ching-Tien Peng)

《Acta Paediatrica Taiwanica》 43卷4期 (2002/08) Pp. 193-198

https://doi.org/10.7097/APT.200208.0193

摘要

本研究分析影響超早産兒存活之因素，並對兩段時期的存活率作了比較，期間分別爲1997年1月至1998年5月、1998年6月至2000年12月。
懷孕週數及出生體重乃影響存活之因素，前後期存活率分別是48.8%(41/84)與55.2%(80/145)。顯著有死亡率差異的分界點，前期爲懷孕24週以下、出生體重700公克以下，後期爲懷孕24週以下、出生體重500公克以下。最小的早産兒：前期爲一個23週、出生體重530公克的女嬰，沒有合併症，且生活正常；後期爲一個懷孕21週、出生體重460公克的女嬰，出院使用居家氧氣治療，於出院後四天突發呼吸暫停與心搏停止，經急診再入院，四天後死亡。
母體轉診至醫學中心生産，以及剖腹生産，在本研究當中，並未顯示存活率提高。新生兒早期死亡率佔新生兒總死亡率一半，這表示出生後的在，尤其第一週的醫療照護仍有待加強！預防早産的發生，可以減少新生兒罹病率及死亡率。但如果有超早産兒即將出生時，積極的治療計劃對於懷孕達24週、體重達500公克者，應屬適當。

關鍵字

超早産兒 ； 存活率 ； 週産期因子

並列摘要

The survival rates and the influential perinatal factors of extremely low birth weight (ELBW) infants were compared between two periods, including January 1997 through May 1998 (Period 1, n=84) and June 1998 through December 2000 (Period 2, n=145). The survival rate was 48.8% (41/84) during Period 1 and 55.2% (80/145) during Period 2. Gestational age (GA) and birth weight (BW) were the most important factors that influenced the survival rate. The cut off levels, below which mortality rates increased significantly, were GA＜24 weeks and BW＜700 gm during Period 1 and GA＜24 weeks and BW＜500 gm during Period 2. During Period 1, the smallest survival was a female infant with GA of 23 weeks and BW of 530 gm who had no complication and lived well. During Period 2, the smallest survival was a female infant with GA of 21 weeks and BW of 460 gm who was discharged with home oxygen therapy. She was admitted again via emergency due to sudden onset of apnea and cardiac arrest 4 days after discharge, and she died 4 days after the 2(superscript nd) admission. Our results did not show any advantages to maternal transfer or delivery by Cesarean section. The early neonatal mortality rate was still high during Period 2 and accounted for 50% of the overall neonatal mortality rate. This implies that further training to improve the neonatal care, especially during the early stage of the first week should be reinforced to reduce neonatal deaths. Prevention of the births of extremely premature infants should be more emphasized to decrease neonatal mortality and morbidity rates. When the delivery of an ELBW infant is impending, an active plan of treatment for all infants of GA≥24 weeks or BW≥500 gm seems appropriate.

並列關鍵字

extremely low birth weight infant ； survival rate ； perinatal factors