การรอดชีวิตและผลการรักษาทารกน้ำหนักน้อยมากในโรงพยาบาลสมุทรสาคร

บทคัดย่อ

Objectives : To determine the survivals, outcomes and perinatal risks of mortality among VLBW infants born in Samutsakorn Hospital.

Materials and methods : This is a retrospective study. Data were collected from medical records of all infants with gestational age more than 26 weeks and birth weight less than 1,500 grams born in Samutsakorn Hospital during the 2 years period between June 1^st 2006 and May 31^st 2008. Antenatal history, perinatal data, neonatal outcome and complication of infants at hospital discharge were included for analysis.

Results : One hundred and one infants with birth weight between 600-1,490 grams were identified (8.7/1,000 live birth). Over all survival rate of very low birth weight (VLBW) infants and extremely low birth weight (ELBW) infants were 79% and 43% respectively. The survivals improved with the increasing of birth weight. The major causes of death were respiratory distress syndrome (RDS) and sepsis. The complication of survivors to hospital discharge was 21%. The major complications were bronchopulmonary dysphasia (BPD) and retinopathy of prematurity (ROP). Perinatal risks of mortality among VLBW infants included gestational age < 28 weeks (P = 0.001), ELBW (P < 0.001), Apgar score at 5 minutes ≤ 5 (P = 0.001) and need endo tracheal intubation in delivery room (P = 0.001). 

Conclusion : The survivals and outcomes among very low birth weight infants born in Samutsakorn Hospital is acceptable. The mortality of extremely low birth weight infants is still high. Improving care for mothers and infants in order to reduce the mortality and complication should be further studied and encouraged.