Risk factors for intelligence and development retardation of survivals in application of mechanical ventilation for treatment of respiratory failure in newborn

XU Ping; MA Jing; ZHOU LI-ying; LI Mei-xue; JIA HUAN-Rong; YANG Qiao-zhi

doi:10.3969/j.issn.1002-266X.2015.37.003

Abstract：Objective To investigate the risk factors for the intelligence and development retardation of survivals in application of mechanical ventilation for the treatment of respiratory failure in neonatal intensive care unit (NICU).Meth-ods The clinical data of 193 cases of infants in NICU who were treated with endotracheal intubation mechanical ventilation were retrospectively analyzed .The relationships of various factors during hospitalization which included maternal complica -tions and perinatal conditions etc .with the intelligence and development retardation were observed .Early intervention guid-ance and follow-up were conducted on the survived , and they were tested for intelligence development at the age of 18 months in order to understand the development of neural development .Results In 436 cases of infants , 193 children were followed up until the age of 18 months after discharge .The follow-up rate was 69 .17%.There were 16 cases of mental ab-normality (8.29%), 36 cases of abnormal movement (18.65%), 13 cases were confirmed cerebral palsy (6.74%);and 13 cases were confirmed the mental abnormalities accompanied with cerebral palsy (16.06%).Through the single factor a-nalysis of risk factors, we found that gestational age ≥37 weeks, the time of endotracheal intubation ≥4 days and hypoxic ischemic encephalopathy (HIE) would affect the intellectual development (all P<0.05).Gestational age <37 weeks, in-tracranial hemorrhage and re-intubation had effect on the motor function (all P<0.05).Significant difference was found between the children who received early intervention and chilled without early intervention (all P<0.001).Multivariable Logistic regression analysis showed that the factors which influenced the mental development were duration of ventilation (OR=1.183), early intervention (OR=0.301) and gestational hypertension (OR=1.910), respectively; the factors which influenced the motor function were duration of ventilation (OR=1.150), HIE (OR=0.387) and endotracheal re-intubation (OR=0.346), respectively.Conclusions The neonates who need early application of mechanical ventilation are the high risk group of neuro-disability in NICU.The factors that affect the development of the intelligence are the venti -lation time, the early intervention and pregnancy induced hypertension .The factors that affect the development of the sports are the ventilation time, HIE and re-intubation.