The onset time of pulmonary hemorrhage is an important factor affecting the prognosis in very low birth weight infants

Abstract

Abstract Background: This retrospective cohort study was conducted to clarify the effect of different onset ages of pulmonary hemorrhage on the survival time in very low birth weight infants (VLBWIs). Methods: The study participants were screened from all VLBWIs admitted to two Chinese neonatal intensive care units from July 31, 2019 to July 31, 2023. The subjects finally included were VLBWIs who survived until the diagnosis of pulmonary hemorrhage was established. This study was retrospectively divided into the death group (n=73) and the survival group (n=54). Results: (1) The death group showed smaller gestational age, lower birth weight, higher proportions of postnatal intubation, grade III-IV respiratory distress syndrome, early onset sepsis, and coagulopathy (p<0.05). (2) The Cox regression analysis showed that the adjusted hazard ratio of onset time is 0.965(95% CI: 0.931-0.998) based on the variables screened by Lasso regression. Restricted cubic spline analysis found the cut-point of onset age is 3 days after birth (P for likelihood ratio test <0.001). (3) The Kaplan-Meier curve showed that infants whose onset age is less than 3 days have a shorter survival time (Log-rank test, p<0.0001). Conclusion: VLBWIs with onset age of pulmonary hemorrhage less than 3 days have a significantly increased risk of death and shorter survival time.