Вопросы современной педиатрии (Dec 2014)

RISK FACTORS FOR THE EARLY NEONATAL MORTALITY IN NEWBORNS WITH VERY LOW AND EXTREMELY LOW BIRTH WEIGHT

  • О. V. Lebedeva,
  • Т. А. Chikina

DOI
https://doi.org/10.15690/vsp.v13i6.1199
Journal volume & issue
Vol. 13, no. 6
pp. 35 – 39

Abstract

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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.

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