基于婴儿期日龄分期的新生儿后期新概念  

Post-newborn period : a new concept of age period in early life after birth

作　　者：陈龙[1] 李婕[2] 王燕[3] 候建明 闫军 王君霞 何志慧[7] 谭书江 蒲向阳 任小玲[10] 陈静[11] 蒋守福 易彬[13] 朱琼 马娟[1] 汪丽[1] 唐仕芳[1] 赵锦宁[1] 李宛卫[1] 李霞[1] 吴芳[1] 龚放[3] 曾毅文 莫运波 谭秋 胡玲 叶海燕 郭林梅 李彦莉[7] 陈远春 姜小华 邓胜勇 魏贵玉 王英[10] 潘洪[10] 王成秀[11] 陈聪[11] 徐瑞峰[13] 史源[15] 无 

机构地区：[1]第三军医大学大坪医院儿科,重庆400042 [2]重庆医科大学第一附属医院妇产科,重庆400014 [3]重庆医科大学附属永川医院儿科,永川402160 [4]三峡中心医院儿童分院,万州404100 [5]重庆市九龙坡区人民医院儿科,重庆400050 [6]解放军兰州总医院,兰州530050 [7]重庆市第九人民医院儿科,重庆400700 [8]重庆市涪陵区中心医院儿科,涪陵408000 [9]重庆市黔江区中心医院儿科,黔江409000 [10]重庆市綦江区人民医院,綦江401420 [11]重庆市第五人民医院儿科,重庆400060 [12]重庆市铜梁区人民医院儿科,铜梁402560 [13]甘肃省妇幼保健院,兰州730050 [14]重庆市合川区妇幼保健院,合川401520 [15]重庆医科大学附属儿童医院,重庆400014 [16]基于婴儿期日龄分期的新生儿后期新概念多中心协作组

出　　处：《中国循证儿科杂志》2017年第4期273-277,共5页Chinese Journal of Evidence Based Pediatrics

基　　金：重庆市科委精准医学重点专项基金:cstc2016shms-ztzx13001;重庆市科委社会民生专项基金:cstc2015shmszx1201114

摘　　要：目的通过调查新生儿期(0~28 d)、新生儿后期(~100 d)和改良婴儿期(~1岁)病死率和死因谱,为新生儿后期新概念提供初步的临床证据支持。方法在中国西部新生儿协作网采用整群随机抽样方法抽取14家医院,采用回顾性横断面调查方法,采集14家医院2004年1月至2013年12月住院婴儿新生儿期、新生儿后期和改良婴儿期的第一出院的或病死的诊断。结果在10年期间,共有155 463例住院婴儿进入本文分析,死亡959例,病死率为6.16‰;新生儿期、新生儿后期和改良婴儿期病死率分别为10.1‰、6.9‰和2.6‰,新生儿后期与新生儿期和改良婴儿期差异均有统计学意义。新生儿期632例死亡病例中前6个死亡原因依次为新生儿窒息、新生儿呼吸窘迫综合征(NRDS)、先天心脏病(CHD)、早产相关疾病(PAD)、婴儿猝死综合征(SIDS)和肺炎,新生儿后期148例死亡病例中前6个死亡原因依次为肺炎、CHD、PAD、腹泻、SIDS和维生素K1缺乏,改良婴儿期188例死亡病例中前6个死亡原因依次为肺炎、CHD、意外伤害、SIDS、PAD和腹泻。新生儿期、新生儿后期和改良婴儿期同时出现的死因性疾病PAD、肺炎、SIDS和CHD,病死率最高是新生儿后期(P<0.001)。结论在未校正胎龄和喂养方式混杂因素的情况下,新生儿后期疾病病死率及其病因具有特殊性,可能具有特别的临床意义。Objective The early life after birth, is very important to growth/development of children a nd health/disease of adult. However, the age boundary is inconsistent among pediatrician now adays. The aim of the present study was to investigate the mortalities and causes of death of the neonatal period, post-newborn period（28 days after birth-100 days） and modified infant period（ 100 days after birth-1 year） for the n e w concept in early life after birth with post-newborn period. Methods We reviewed retrospectively the dead children of fourteen hospitals in west China from 2004 to 2013 a nd investigated the mortalities and causes of death of the neonatal period, post-newborn period and modified infant period. Results During 2004-2013, 155 463 infants aged 0 to 1 year were admitted to the hospitals, a nd 959 died. The total infant mortality was 6.16%. Significant differences were found in the mortality among the three periods （ 10.1‰ vs 6‰ vs 2.6‰, P 〈0.001）. Three main causes of death were different among three period： they were neonatal respiratory distress syndrome, neonatal asphyxia and congenital heart disease （ C H D ） in the neonatal period, pneumonia, CHD and premature-associated disease （ PAD ） in the post-newborn period, and pneumonia, CHD and accidental injuries in the modified infant period. Otherwise, four major diseases simultaneously appearing during the three periods （PAD , pneumonia, sudden infant death syndrome a nd CHD ） s howed inverse ” U ” shape changes from the neonatal period to the modified infant period, a nd the highest mortality occurred in the post-newborn period （P 〈0.001） . Conclusion Without gestational age and feeding mode being corrected as confounding factors, the mortality a nd etiology of post-newborn period have particularity, and which may mean special clinical values. In the future, more studies are needed to clarify the new-built concept a nd in

关 键 词：新生儿期 新生儿后期 改良婴儿期 早产相关性疾病 先天性心脏病 

分 类 号：R722.1[医药卫生—儿科]