"Clinical characteristics and outcomes in neonates with perinatal acute respiratory distress syndrome in China: A national, multicentre, cross-sectional study"

作者全名："Chen, Long; Li, Jie; Shi, Yuan"

作者地址："[Chen, Long; Shi, Yuan] Chongqing Med Univ, Childrens Hosp, Natl Clin Res Ctr Child Hlth & Disorders, Dept Neonatol,Minist Educ,Key Lab Child Dev & Dis, Chongqing 400014, Peoples R China; [Chen, Long; Shi, Yuan] China Int Sci & Technol Cooperat Base Child Dev &, Chongqing 400014, Peoples R China; [Chen, Long; Shi, Yuan] Chongqing Key Lab Pediat, Chongqing 400014, Peoples R China; [Li, Jie] Chongqing Med Univ, Affiliated Hosp 1, Dept Obstet & Gynecol, Chongqing 400014, Peoples R China"

通信作者："Shi, Y (通讯作者)，Chongqing Med Univ, Childrens Hosp, Natl Clin Res Ctr Child Hlth & Disorders, Dept Neonatol,Minist Educ,Key Lab Child Dev & Dis, Chongqing 400014, Peoples R China.; Shi, Y (通讯作者)，China Int Sci & Technol Cooperat Base Child Dev &, Chongqing 400014, Peoples R China.; Shi, Y (通讯作者)，Chongqing Key Lab Pediat, Chongqing 400014, Peoples R China."

来源：ECLINICALMEDICINE

ESI学科分类：　

WOS号：WOS:000898807700017

JCR分区：Q1

影响因子：15.1

年份：2023

卷号：55

期号：　

开始页：　

结束页：　

文献类型：Article

关键词：Neonate; Acute respiratory distress syndrome; Bronchopulmonary dysplasia; Mortality; Epidemiology

摘要："Background Neonatal acute respiratory distress syndrome (NARDS) was defined in 2017 and the epidemiological data remain unknown. Our objective was to explore aetiological factors, clinical characteristics and outcomes in patients with perinatal NARDS. Methods A multicentre, prospective, cross-sectional study was performed in 58 tertiary neonatal intensive care units in China from Jan 1, 2018 to June 30, 2019. Neonates diagnosed with NARDS were included. Primary outcomes were aetiological factors, clinical characteristics and outcomes. Binary logistic regression and multivariate cox proportional regression were performed to identify independent predictors for bronchopulmonary dysplasia (BPD) and/or death or single death. This study was registered with ClinicalTrials.Gov, NCT03311165. Findings Among 70,013 admitted neonates, the incidence of NARDS was 1.44% (1005). The cumulative incidences were 65.6%, 86.7%, 94.1% within one, two and three days after birth. The median gestational age and birth weight were 36.4 weeks and 2700 g. Three main aetiological triggers included pneumonia (58.1%), asphyxia (24.3%) and early-onset sepsis (EOS) (21.3%). BPD and/or death was observed in 213 (21.2%) infants, consisting 104 (10.3%) BPD and 126 (12.6%) deaths. The numbers of mild, moderate and severe NARDS were 537 (53.4%), 286 (28.4%) and 182 (18.2%). Two or more doses of surfactant was associated with increased mortality as compared with one or less doses of surfactant (odds ratio [OR] 1.93, 95% confidence interval [CI] 1.20-3.10, P = 0.006). Similarity also appeared in the comparison between EOS and non-EOS triggers (OR 1.57, 95% CI 1.06-2.33, P = 0.023). Interpretation NARDS incidence was 1.44% and the three main aetiologies were pneumonia, asphyxia and EOS. The cumulative incidences were 65.6%, 86.7%, and 94.1% within one, two and three days after birth. Our results suggested that two or more doses of surfactant increased mortality compared with one or less doses of surfactant. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd."

基金机构：National Clinical Research Center of China and Clinical Medical Study Program of Children's Hospital of Chongqing Medical University [NCRC-2019-GP-13]; Natural Science Foundation of Chongqing [cstc2020jcyjmsxmX0197]

基金资助正文：The National Clinical Research Center of China and Clinical Medical Study Program of Children's Hospital of Chongqing Medical University (NCRC-2019-GP-13) and Natural Science Foundation of Chongqing (cstc2020jcyjmsxmX0197).