Frontiers in Pediatrics (Feb 2024)

Survival and morbidity in very preterm infants in Shenzhen: a multi-center study

  • Tingting Li,
  • Guofei Zhang,
  • Rui Li,
  • Shengnan He,
  • Fangshi Zhang,
  • Xudong Yan,
  • Zhangbin Yu,
  • Yingmei Xie,
  • Shenzhen Neonatal Data Network,
  • Guichao Zhong,
  • Cheng Chen,
  • Xueling Zhuang,
  • Yanping Guo,
  • Huixian Qui,
  • Qianshen Zhang,
  • Jinxing Feng,
  • Ya Pan,
  • Jiaoyu Mao,
  • Rui Wang,
  • Gerun Zhang,
  • Qianqian Fan,
  • Xiaoli Chen,
  • Yuefeng Li,
  • Xiaoguang Zhou,
  • Erya Ying,
  • Zhihong Zhong,
  • Binyu Ni,
  • Yanrong Wang,
  • Hong Tong,
  • Gang Liu

DOI
https://doi.org/10.3389/fped.2023.1298173
Journal volume & issue
Vol. 11

Abstract

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ObjectiveTo analyze survival and morbidity among very preterm infants (VPIs) in Shenzhen and explore factors associated with survival without major morbidity.MethodsBetween January 2022 and December 2022, 797 infants were admitted to 25 neonatal intensive care units in Shenzhen with gestational age (GA) < 32 weeks, excluded discharged against medical advice, insufficient information, and congenital malformation, 742 VPIs were included. Comparison of maternal and neonate characteristics, morbidities, survival, and survival without major morbidities between groups used Mann Whitney U test and X2 test, multivariate logistic regression was used to analyze of risk factors of survival without major morbidities.ResultsThe median GA was 29.86 weeks (interquartile range [IQR], 28.0–31.04), and the median birth weight was 1,250 g (IQR, 900–1,500). Of the 797 VPIs, 721 (90.46%) survived, 53.52% (38 of 71) at 25 weeks’ or less GA, 86.78% (105 of 121) at 26 to 27 weeks' GA, 91.34% (211 of 230) at 28 to 29 weeks' GA, 97.86% (367 of 375) at 30 to 31 weeks' GA. The incidences of the major morbidities were moderate-to-severe bronchopulmonary dysplasia,16.52% (113 of 671); severe intraventricular hemorrhage and/or periventricular leukomalacia, 2.49% (17 of 671); severe necrotizing enterocolitis, 2.63% (18 of 671); sepsis, 2.34% (16 of 671); and severe retinopathy of prematurity, 4.55% (27 of 593), 65.79% (450 of 671) survived without major morbidities. After adjustment for GA, birth weight, and 5-min Apgar score, antenatal steroid administration (OR = 2.397), antenatal magnesium sulfate administration (OR = 1.554) were the positivity factors to survival without major morbidity of VPIs, however, surfactant therapy (OR = 0.684,), and delivery room resuscitation (OR = 0.626) that were the negativity factors.ConclusionsThe present results indicate that survival and the incidence of survival without major morbidities increased with GA. Further, antenatal administration of steroids and magnesium sulfate, surfactant therapy, and delivery room resuscitation were pronounced determinants of survival without morbidities.

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