Risk factors for neonatal pulmonary hemorrhage in the neonatal intensive care unit of a municipal hospital

Abstract:

Objective To investigate the risk factors for neonatal pulmonary hemorrhage (NPH) in the neonatal intensive care unit (NICU) of a municipal hospital, and to provide a basis for the early identification and treatment of NPH. Methods A total of 112 neonates who were admitted to the NICU of Shaoyang Central Hospital of Hunan Province and diagnosed with NPH were enrolled as the case group. A nested case-control method was used to select, as a control group (n=224), the neonates who underwent the treatment with an assisted mechanical ventilator and did not experience pulmonary hemorrhage. Univariate analysis and unconditional logistic regression analysis were used to identify the high risk factors for NPH. Results The univariate analysis showed that compared with the control group, the case group had significantly higher incidence rates of gestational diabetes and cholestasis in mothers, cesarean delivery, gestational age < 34 weeks, 5-minute Apgar score ≤ 5, birth weight < 2 500 g, heart failure and disseminated intravascular coagulation (DIC) before the development of NPH, partial pressure of oxygen/fraction of inspired oxygen (oxygenation index, OI) ≤ 100, and a reduction in mean platelet volume. The multivariate logistic regression analysis showed that DIC, heart failure, and OI ≤ 100 were independent risk factors for NPH (OR=33.975, 3.975, 1.818 respectively; P < 0.05). Conclusions Heart failure, OI ≤ 100, and DIC are risk factors for the development of NPH in the NICU of the municipal hospital.