Objective To study the correlation between adverse clinical outcomes and early postnatal weight loss(representing the results of fluid management)during hospitalization in extremely premature infants(EPIs).Methods From January 2019 to March 2023,EPIs(gestational age(GA)＜28 weeks)admitted to neonatal intensive care unit(NICU)of our hospital were retrospectively analyzed.According to weight loss(WL)within the first 3 d after birth,the infants were assigned into no-WL group,WL＜6％group,WL 6％-10％group and WL＞10％group.The following items were compared among the four groups:fluid intake within the first 7 d after birth,the incidences of hemodynamically significant patent ductus arteriosus(hsPDA),PDA requiring surgical ligation,duration of invasive mechanical ventilation,≥stage Ⅱ necrotizing enterocolitis(NEC),grade 3-4 intraventricular hemorrhage(IVH),moderate bronchopulmonary dysplasia(BPD),severe BPD,mortality rates and total length of hospital stay.Results A total of 119 EPIs were enrolled,including 41 in no-WL group,22 in WL＜6％group,31 in WL 6％-10％group and 25 in WL＞10％group.Among the four groups,no significant differences existed in fluid intake on d1 and d5-d7 after birth(P＞0.05).WL 6％-10％and＞10％groups had significantly lower fluid intake during d2-d4 than no-WL group(P＜0.05).On d4,WL 6％-10％and＞10％groups had lower fluid intake than WL＜6％and no-WL groups(P＜0.05).WL 6％-10％and＞10％groups showed lower incidences of hsPDA than no-WL group(P＜0.05).WL＞10％group had lower incidences of ≥stage Ⅱ NEC,moderate BPD,shorter duration of invasive mechanical ventilation and total hospital stay than no-WL group(P＜0.05).No significant differences existed in the incidences of PDA requiring surgical ligation,grade 3-4 IVH,severe BPD and mortality rates among the four groups(P＞0.05).Conclusions For EPIs,a certain degree of WL within the first 3 d after birth is beneficial to reduce the incidences of hsPDA,NEC,moderate BPD,duration of invasive mechanical ventilation and total hospital stay.Focusing on body weight is helpful for a more optimal fluid management strategy in the early postnatal period.
维普
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