A birth population-based survey of preterm morbidity and mortality by gestational age

BMC Pregnancy and Childbirth

Zhaojun Pan¹  Hongni Yue²  Xiaoqiong Li³  Tingting Qi³  Ying Dong⁴  Bo Sun⁴  Xiaojing Guo⁴  Hui Wang⁵  Xiaoqin Zhu⁵ 

[1] Department of Neonatology and Unit of Population Health Information, Huai’an Women and Children’s Hospital, 104 South Ren Min Road, 223002, Huai’an, Jiangsu, China;Department of Neonatology and Unit of Population Health Information, Huai’an Women and Children’s Hospital, 104 South Ren Min Road, 223002, Huai’an, Jiangsu, China;Unit of Population Health Information, Huai’an Women and Children’s Hospital, 223002, Huai’an, Jiangsu, China;Department of Obstetrics, Huai’an Women and Children’s Hospital, 223002, Huai’an, Jiangsu, China;The NCH Key Laboratory of Neonatal Diseases, National Children’s Medical Center, Children’s Hospital of Fudan University, 201102, Shanghai, China;Unit of Population Health Information, Huai’an Women and Children’s Hospital, 223002, Huai’an, Jiangsu, China;

关键词: Birth population;    Prevalence;    Preterm;    Morbidity;    Mortality;    Gestation;    Regional perinatal-neonatal network;   

DOI  :  10.1186/s12884-021-03726-4

来源: Springer

【 摘 要 】

BackgroundDespite 15–17 millions of annual births in China, there is a paucity of information on prevalence and outcome of preterm birth. We characterized the outcome of preterm births and hospitalized preterm infants by gestational age (GA) in Huai’an in 2015, an emerging prefectural region of China.MethodsOf 59,245 regional total births, clinical data on 2651 preterm births and 1941 hospitalized preterm neonates were extracted from Huai’an Women and Children’s Hospital (HWCH) and non-HWCH hospitals in 2018–2020. Preterm prevalence, morbidity and mortality rates were characterized and compared by hospital categories and GA spectra. Death risks of preterm births and hospitalized preterm infants in the whole region were analyzed with multivariable Poisson regression.ResultsThe prevalence of extreme, very, moderate, late and total preterm of the regional total births were 0.14, 0.53, 0.72, 3.08 and 4.47%, with GA-specific neonatal mortality rates being 44.4, 15.8, 3.7, 1.5 and 4.3%, respectively. There were 1025 (52.8% of whole region) preterm admissions in HWCH, with significantly lower in-hospital death rate of inborn (33 of 802, 4.1%) than out-born (23 of 223, 10.3%) infants. Compared to non-HWCH, three-fold more neonates in HWCH were under critical care with higher death rate, including most extremely preterm infants. Significantly all-death risks were found for the total preterm births in birth weight <  1000 g, GA < 32 weeks, amniotic fluid contamination, Apgar-5 min < 7, and birth defects. For the hospitalized preterm infants, significantly in-hospital death risks were found in out-born of HWCH, GA < 32 weeks, birth weight <  1000 g, Apgar-5 min < 7, birth defects, respiratory distress syndrome, necrotizing enterocolitis and ventilation, whereas born in HWCH, antenatal glucocorticoids, cesarean delivery and surfactant use decreased the death risks.ConclusionsThe integrated data revealed the prevalence, GA-specific morbidity and mortality rate of total preterm births and their hospitalization, demonstrating the efficiency of leading referral center and whole regional perinatal-neonatal network in China. The concept and protocol should be validated in further studies for prevention of preterm birth.

【 授权许可】

CC BY