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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: To provide preliminary clinical evidence for the new concept of late neonatal period by investigating the mortality and neonatal death (neonatal) (0 ~ 28 days), neonatal (~ 100 days) and improved infant (~ 1 years) Methods A total of 14 hospitals were selected by cluster random sampling method in the western neonatal cooperation network in China. Retrospective cross-sectional investigation was used to collect data from January to December 2013 in newborns, newborns, Improve first discharge or death diagnosis in infancy. Results A total of 155 463 hospitalized infants were enrolled in this study during the 10-year period, with 959 deaths and a case fatality rate of 6.16 ‰. The neonatal, neonatal and improved infancy mortality rates were 10.1 ‰, 6.9 ‰ and 2.6 ‰, respectively. Neonatal late and neonatal and improved infants differences were statistically significant. Among the 632 neonatal deaths, the first six deaths were neonatal asphyxia, neonatal respiratory distress syndrome (NRDS), congenital heart disease (CHD), preterm birth-related diseases (PAD), sudden infant death syndrome (SIDS) Among the 148 deaths in the late neonatal period, the top 6 causes of death were pneumonia, CHD, PAD, diarrhea, SIDS and vitamin K1 deficiency. Among the 188 deaths, the first 6 deaths were pneumonia, CHD , Accidental injuries, SIDS, PAD and diarrhea. PAD, pneumonia, SIDS and CHD, the most common cause of death from neonatal, late neonatal and neonatal infancy, were the highest mortality rates in late neonates (P <0.001). Conclusion In the unadjusted gestational age and feeding conditions confounding factors, late neonatal mortality and its etiology have particularities may have special clinical significance.