Correlation between Early Fluid Load and Pulmonary Hemorrhage in very Low Birth Weight Infants

GUO Yanyan; LOU Chunyan; LIU Yuning; WANG Huijie; ZHANG Lei

doi:10.16458/j.cnki.1007-0893.2025.13.001

Abstract：Objective To investigate the influencing factors of pulmonary hemorrhage in very low birth weight infants(VLBWI)and the relationship between early fluid overload and pulmonary hemorrhage.Methods A total of 50 VLBWI with pulmonary hemorrhage admitted to the Department of Neonatology at Henan Provincial People's Hospital between January 2018 and December 2024 were selected as a pulmonary hemorrhage group.Another 100 VLBWI without pulmonary hemorrhage during the same period were selected as a non-pulmonary hemorrhage group.General data,early fluid intake,and outcomes were compared between the two groups.Multivariate logistic regression analysis was performed to identify factors associated with pulmonary hemorrhage in VLBWI.The predictive value of early fluid intake for pulmonary hemorrhage was evaluated using receiver operating characteristic(ROC)curve analysis.Results Compared with the non-pulmonary hemorrhage group,the pulmonary hemorrhage group had lower gestational age,higher incidence of grade Ⅲ-Ⅳ respiratory distress syndrome(RDS)and patent ductus arteriosus(PDA),lower platelet count(PLT),and higher fluid intake during the first three days,with statistically significant differences(P<0.05).Multivariate analysis indicated that lower gestational age,grade Ⅲ-Ⅳ RDS,PDA,low PLT,and higher average fluid intake during the first three days were risk factors for pulmonary hemorrhage in VLBWI(P<0.05).The ROC curve showed a sensitivity of 76.00%and a specificity of 77.00%,with an area under the curve(AUC)of 0.814(95%CI:0.743-0.873).The mortality rate and incidence of bronchopulmonary dysplasia(BPD)were higher in the pulmonary hemorrhage group,and the duration of mechanical ventilation was longer compared to the non-pulmonary hemorrhage group(P<0.05).Conclusion Gestational age,grade Ⅲ-Ⅳ RDS,PDA,PLT,and early fluid intake are all factors influencing the risk of pulmonary hemorrhage in VLBWI.Those who experience pulmonary hemorrhage have a higher probability of adverse outcomes.