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2017 — 2023年深圳市7 465例早产儿出院后随访状况分析

Follow-up status of 7 465 preterm infants after discharge in Shenzhen from 2017 to 2023

    摘要
  • 摘要:
    目的 了解早产儿随访现状及存在的问题，探索提高早产儿出院后系统管理率的方法。
    方法 选取2017年8月 — 2023年7月自愿到深圳市妇幼保健院高危儿门诊就诊的满2周岁的7 465例早产儿为研究对象。了解三级甲等妇幼保健院高危儿门诊中早产儿的构成及不同出生胎龄早产儿在24月龄以内的随访情况，并采用logistic回归分析早产儿随访率的影响因素。
    结果 7 465例早产儿中，超早产儿451例（6.04%）、极早产儿1 394例（18.67%）、中期早产儿1 464例（19.61%）、晚期早产儿4 156例（55.68%）。小胎龄、低体重早产儿的随访依从性较好，其中 < 28周的超早产儿随访率最高，矫正6、12、18、24月龄时的随访率分别为84.92%、62.31%、44.79%、48.12%。早产儿在矫正6月龄后随访率明显降低，超早产儿、极早产儿、中期早产儿及晚期早产儿在矫正12月龄时的随访率分别为62.31%、47.27%、45.49%、45.67%，矫正24月龄时的随访率分别为48.12%、33.64%、16.26%、15.16%，差异均有统计学意义（χ2 = 46.746、χ2 = 442.225，均P < 0.001）。经logistic回归分析显示，男童、出生孕周小、出生体重低、母亲受教育程度高、第一胎、双胎或多胎儿的随访率较高。
    结论 早产儿家长对出院后的随访认知不一，普遍对早期（6月龄以内）的随访较重视，而忽视12月龄及以后的随访。应进一步加强对早产儿家长出院后随访重要性的宣教，同时按疾病的程度实行三级网络管理，以提高早产儿出院后的系统管理率。

     

    Abstract:
    Objective To investigate the current situation and problems by following up premature infants, so as to improve the system management rate of them after discharge.
    Methods Based on data analysis of all follow-up infants ≤ 2 years at high-risk clinic in Shenzhen Maternity & Child Healthcare (MCH) hospital from August 2017 to July 2023, we tried to investigate the composition of premature infants in the high-risk clinic in tertiary MCH hospital and follow up premature infants with different gestational age within 24 months old. Logistic regression analysis was used to analyze the factors associated with follow-up rate of premature infants.
    Results Among the 7 465 premature infants, 451 were extremely premature (6.04%), 1 394 were very premature (18.67%), 1 464 were moderately preterm (19.61%), and 4 156 were late premature (55.68%). Premature infants with good follow-up compliance were those with small and medium gestational age and low birth weight. Among them, the follow-up rate of extremely premature infants < 28 weeks was the highest, with the follow-up rates at corrected age of 6, 12, 18, and 24 months (84.92%, 62.31%, 44.79%, and 48.12%, respectively). The follow-up rate of premature infants after corrected age of 6 months decreased significantly. The follow-up rates of extremely premature infants, very premature infants, moderately preterm infants and late preterm infants at 12 months and 24 months of corrected age were 62.31%, 47.27%, 45.49%, and 45.67%, and 48.12%, 33.64%, 16.26% and 15.16% respectively, and the differences were statistically significant (χ2 = 46.746, χ2 = 442.225, all P < 0.001). Logistic regression analysis showed that follow-up rates of boys, small gestational age, low birth weight, mothers with high education background, first birth, twins or multiple fetuses were higher.
    Conclusion Perception to follow-up after discharge are not identical among parents of preterm infants. They pay more attention to the early follow-up (≤ 6 months), and ignore 12 months and subsequent follow ups. Health education of the significance of follow-up after discharge should be strengthened, three-tie network management based on the extent of disease should be implemented concurrently, so as to improve the system management rate of preterm infants after discharge.

     

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