ĐÁNH GIÁ KẾT QUẢ ĐIỀU TRỊ VÀ CÁC YẾU TỐ LIÊN QUAN ĐẾN TỬ VONG Ở TRẺ SƠ SINH SINH NON DƯỚI 32 TUẦN TẠI KHOA NHI – SƠ SINH BỆNH VIỆN PHỤ SẢN THÀNH PHỐ CẦN THƠ NĂM 2023-2024

Abstract

Background: Premature birth is consistently confronted with numerous risk factors and severe complications, ranking as the second leading cause of death in children under 5 years old and the foremost direct cause of mortality in the first month after birth. Objectives: 1) To determine the rate of complications associated with preterm birth in infants born at less than 32 weeks gestational age. 2) To survey the treatment interventions in infants born preterm at less than 32 weeks gestational age. 3) Determine the mortality rate and some factors related to death in premature infants born under 32 weeks. Subjects and Methods: A cross-sectional descriptive study of 140 preterm infants born at less than 32 weeks gestational age at Can Tho Obstetrics and Pediatrics Hospital from February 2023 to March 2024. Results: The rate of male was 57,9%, the average gestational age was 29,95 ± 1,96 weeks and the infant birth weight was 1275 ± 358 gram. The incidence of complications ralated to preterm infants: respiratory distress syndrome (93,6%), cơn ngưng thở (98,6%), late-onset pneumonia (42,9%,) early neonatal infection (28,6%), late-onset sepsis (27,1%), PDA requires pharmacological intervention (23,6%), necrotising entetocolitis (20,0%), chronic lung disease (17,1%), hypoglycemia (15,0%), intraventricular haemorrhage (13,6% ) and 7,1% ROP has treatment indications, 5,0% pulmonary hemorrhage and 2,1% pneumothorax. Treatment interventions: 99.3% of infants required postnatal resuscitation, with 90% receiving NCPAP resuscitation, 94.3% requiring NCPAP treatment, and 21.4% requiring mechanical ventilation during treatment, 35.7% received surfactant, 95.8% required total parenteral nutrition, and 40% required packed red blood cell transfusion, 95.8% required total parenteral nutrition, and 40% required packed red blood cell transfusion. The success rate 87.2%, death rate 7.1%, rate of mortality based on gestational age were 55,6%, 0%, 5,0% and 4,3% at < 26 weeks, 26 -< 28 weeks, 28 -< 30 weeks and 30 -< 32 weeks, respectively. The lowest gestational age successfully supported was 24.6 weeks, with a birth weight of 680g. Factors that increase the risk of infant mortality are: gestational age < 28 weeks OR =4,08, KTC 95% = 1,09-15,25, p=0,041, birth weight < 1000g OR =6,82, KTC 95% = 1,77-26,21, p=0,006, respiratory distress syndrome grade 3-4 OR =4,78, KTC 95% = 1,17-19,48, p=0,034, late-onset sepsis OR =31,67, KTC 95% = 3,84-261,13, p<0,001, pulmonary hemorrhage OR =60, KTC 95% = 9,27-388,51, p=0,001, necrotizing enterocolitis OR =6,18, KTC 95% = 1,62-23,62, p=0,012 and cerebral hemorrhage OR =11,2, KTC 95% = 2,77-45,34, p=0,002.  Conclusion: The rate of hospital admissions due to premature rupture of membranes is high. Complications associated with preterm birth such as chorioamnionitis, hospital-acquired pneumonia, and late-onset sepsis are prevalent. Mortality rates remain elevated in the < 26 weeks gestational age group. Factors that increase the risk of infant mortality are: gestational age < 28 weeks, birth weight < 1000g, respiratory distress syndrome grade 3-4, late-onset sepsis, pulmonary hemorrhage, necrotizing enterocolitis and intraventricular haemorrhage.