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标题：Outcomes of neonates with perinatal asphyxia at a tertiary academic hospital in Johannesburg, South Africa
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作者：N Padayachee ; DE Ballot
期刊名称：South African Journal of Child Health
印刷版ISSN：1994-3032
电子版ISSN：1999-7671
出版年度：2013
卷号：7
期号：3
页码：89-94
语种：English
出版社：African Journals Online
摘要：Background . Perinatal asphyxia is a signicant cause of death and disability. Objective . To determine the outcomes (survival to discharge and morbidity aer discharge) of neonates with perinatal asphyxia at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). Methods . is was a descriptive retrospective study. We reviewed information obtained from the computerised neonatal database on neonates born at CMJAH or admitted there within 24 hours of birth between 1 January 2006 and 31 December 2011, with a birth weight of >1 800 g and a 5-minute Apgar score <6. Results . Four hundred and y infants were included in the study; 185 (41.1%) were females, the mean birth weight (± standard deviation) was 3 034.8±484.9 g, and the mean gestational age was 39.1±2.2 weeks. Most of the infants were born at CMJAH (391/450, 86.9%) and by normal vaginal delivery (270/450, 60.0%). e overall survival rate was 86.7% (390/450). Forty-two infants were admitted to the intensive care unit (ICU). e ICU survival rate was 88.1% (37/42). Signicant predictors of survival were place of birth (p=0.006), mode of delivery (p=0.007) and bag-mask ventilation at birth (p=0.040). Duration of hospital stay (p=0.000) was signicantly longer in survivors than in non-survivors (6.5±6.6 days v. 2.8±9.8 days). e remaining factors, namely gender, antenatal care, chest compressions, diagnosis of meconium aspiration syndrome or persistant pulmonary hypertension, did not dier signicantly between the two groups. e rate of perinatal asphyxia (5-minute Apgar score <6) was 4.7/1 000 live births, and there was evidence of hypoxic ischaemic encephalopathy (HIE) in 3.6/1 000 live births. Of the 390 babies discharged from CMJAH, 113 (29.0%) had follow-up records to a mean corrected age of 5.9±5.0 months. e majority (90/113, 79.6%) had normal development. Conclusions . (i) e high overall survival and survival aer ICU admission provides a benchmark for further care; (ii) obtaining adequate data for long-term follow-up was not possible with the existing resources – surrogate early markers of outcome and/or more resources to ensure accurate follow-up are needed; and (iii) the high incidence of HIE suggests that a therapeutic hypothermia service, including a longterm follow-up component, would be benecial.