Çok düşük doğum ağırlıklı prematüre yenidoğanlarda pulmoner kanama sıklığı ve risk faktörleri

Abstract

Amaç: Pulmoner kanama prematüre bebeklerde önemli bir mortalite nedenidir. Bu çalışmada çok düşük doğum ağırlıklı prematüre bebeklerde pulmoner kanama sıklığı ve pulmoner kanama ilişkili risk faktörlerinin belirlenmesi amaçlanmıştır. Gereçler ve Yöntem: Şanlıurfa Eğitim Araştırma Hastanesi Yenidoğan Yoğun Bakım Ünitesi’ne Eylül 2017 ve Şubat 2019 tarihleri arasında yatırılan doğum ağırlığı ≤1500 gram, gestasyon haftası ≤32 hafta olan prematüre bebekler retrospektif olarak çalışmaya alındı. Pulmoner kanama gelişen bebeklerin özellikleri ve risk faktörleri kontrol grubuyla karşılaştırıldı. Bulgular: İki yüz doksan sekiz çok düşük doğum ağırlıklı prematüre bebek çalışmaya dahil edildi. Hastaların %20,8’inde pulmoner kanama gelişti. Pulmoner kanama gelişen grupta ortalama gestasyon haftası (26,5 ± 1,9) ve doğum ağırlığı (892 ± 269) anlamlı olarak düşüktü (p<0,001). Doğum ağırlığı (OR = 0,99 [%95 CI = 0,99-0,99]; p = 0,037), antenatal steroid uygulanmamış olması (OR = 3,26 [%95CI = 1,246-8,54]; p = 0,016) ve doğum salonunda entübasyon varlığı (OR = 5,32 [%95CI = 1,694-16,72]; p = 0,004) pulmoner kanama açısından anlamlı risk faktörleri olarak saptandı. Sonuç: Doğum ağırlığının düşüklüğü, antenatal steroid uygulanmaması ve doğum salonunda entübasyon gereksinimi pulmoner kanama riskini artırmaktadır. Antenatal bakımı iyileştirmek pulmoner kanama sıklığını azaltabilir.

Keywords

• prematürite
• yenidoğan
• pulmoner kanama

The frequency of pulmonary hemorrhage and associated risk factors in very low birth weight premature newborns

Abstract

Aim: Pulmonary hemorrhage is an important reason for mortality in premature infants. In this study we aimed to evaluate the frequency of pulmonary hemorrhage and associated risk factors in very low birth weight premature infants. Materials and Method: Premature infants with birth weight ≤1500 g and gestational age ≤32 weeks admitted to Sanliurfa Training and Research Hospital Neonatal Intensive Care Unit between September 2017 and February 2019 were included retrospectively in the study. The characteristics and risk factors of infants with pulmonary hemorrhage were compared with the control group. Results: Two hundred and ninety eight infants were included in the study. Pulmonary hemorrhage developed in 20.8% of patients. Mean gestational age (26.5 ± 1.9) and birth weight (892 ± 269) were significantly lower in pulmonary hemorrhage group (p<0.001). Birth weight (OR = 0.99 [%95 CI = 0.99-0.99]; p = 0.037), lack of antenatal steroid therapy (OR = 3.26 [%95CI = 1.246-8.54]; p = 0.016) and intubation in delivery room (OR = 5.32 [%95CI = 1.694-16.72]; p = 0.004) were significant risk factors for development of pulmonary hemorrhage. Conclusion: Lower birth weight, lack of antenatal steroid therapy and intubation in delivery room increase the risk of pulmonary hemorrhage. Improving antenatal care may reduce pulmonary hemorrhage.

Keywords

• prematurity
• newborn
• pulmonary hemorrhage

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