Table_2_Mortality and Morbidity in Infants <34 Weeks' Gestation in 25 NICUs in China: A Prospective Cohort Study.docx

Objectives: To describe the rates and variability of mortality and morbidity of preterm infants born in China.
Methods: This prospective cohort study included infants born at <34 weeks' gestation and admitted to 25 NICUs within 7 days of birth between May 1st, 2015 and April 30th, 2016. Infants were followed until death or NICU discharge. The primary outcome was a composite of mortality or any major morbidity (sepsis, necrotizing enterocolitis, intraventricular/periventricular leukomalacia, retinopathy of prematurity, and bronchopulmonary dysplasia) in infants who received complete care following medical advice. Secondary outcomes included rate of discharge against medical advice, mortality and individual morbidities.
Results: Of the 8,065 infants, 6,852 (85%) received complete care and 1,213 (15%) were discharged against medical advice. Among infants who received complete care, the rate of the composite outcome was 27% (1,827/6,852), mortality 4% (248/6,852), sepsis 14% (990/6,852), necrotizing enterocolitis 3% (191/6,550), intraventricular hemorrhage/periventricular leukomalacia 7% (422/6,307), retinopathy of prematurity 2% (67/3,349), and bronchopulmonary dysplasia 9% (616/6,852). There were significant variations between NICUs for all outcomes.
Conclusions: Discharged against medical advice, mortality, and morbidity rates for preterm infants <34 weeks' gestation are high in China with significant variations between NICUs.

研究目标：描述中国境内出生的胎龄<34周早产儿的死亡率与发病率及其变异特征。
方法：本前瞻性队列研究纳入2015年5月1日至2016年4月30日期间，出生后7日内收入25家新生儿重症监护病房（Neonatal Intensive Care Unit, NICU）的胎龄<34周早产儿。对受试者进行随访直至其死亡或从NICU出院。主要结局指标为遵循医嘱接受完整诊疗的婴儿的复合终点事件，即死亡或任意一种严重并发症（败血症、坏死性小肠结肠炎、脑室内/脑室周围白质软化症、早产儿视网膜病以及支气管肺发育不良）。次要结局指标包括出院未遵医嘱率、死亡率以及各类单独并发症的发生率。
结果：本研究共纳入8065例婴儿，其中6852例（85%）接受了完整诊疗，1213例（15%）出院未遵医嘱。在接受完整诊疗的婴儿中，复合终点事件发生率为27%（1827/6852），死亡率为4%（248/6852），败血症发生率为14%（990/6852），坏死性小肠结肠炎发生率为3%（191/6550），脑室内出血/脑室周围白质软化症发生率为7%（422/6307），早产儿视网膜病发生率为2%（67/3349），支气管肺发育不良发生率为9%（616/6852）。各NICU间所有结局指标均存在显著差异。
结论：中国境内胎龄<34周的早产儿出院未遵医嘱率、死亡率及并发症发生率均较高，且各NICU间存在显著差异。