张巍，女，主任医师，教授，新生儿科主任，儿科主任，围产医学科副主任、医学硕士，硕士生导师，1982年毕业于北京第二医学院（现首都医科大学）儿科系，获学士学位。临床从事新生儿NICU、新生儿疾病、高危儿随访、新生儿疾病筛查、儿科疾病、儿童保健等，承担卫生部十年百项推广项目--新生儿听力筛查适宜技术。研究方向：早产儿预后相关因素,噪声与新生儿听力障碍；新生儿听力筛查的可行性研究。
Why pay special attention to preterm children
为什么要特别关注早产儿
早产儿是全球人类死亡的主要原因之一
全世界每年超过300万新生儿死亡, 并发症导致死亡病例中早产儿为35%
儿童5岁以下肺炎死亡病例中,早产儿占位第二, 在中高收入国家则占位第一
早产儿也是人类生命过程中远期死亡重要原因
Blencowe et al.Reproductive Health 2013, 10(Suppl 1):S2
Preterm baby survival and care round the world
全球早产婴儿生存与管理状况
Estimated distribution of causes of 3.1 million neonatal deaths in193 countries in 2010. Source: Updated from Lawn et al., 2005, using data from2010 published in Liu L, et al., 2012.
Blencoweet al. Reproductive Health 2013, 10(Suppl 1):S2
Figure,Pretermbirthsin 2010,Source,Blencowe,H,etal.(2012)Chapter2:15millionpretermbirths:Priorities for action based on national,regional and globalestimates,In 80m Too Soon;the Global ActionReport on Preterm Birth. http://www.who.int/pmnch/media/new/2012/botntoosoon_chapter2.pdf2012[79].Notapplicable=non WHO Members State
Figure 2. Increasing survival gap for preterm babiesaround the world: Regional variation in preterm birth as direct cause ofneonatal deaths showing change between 2000 to 2010. Source: Born Too Soon, Chapter5 . Data from Child Health Epidemiology Reference Group and WorldHealth Organization estimates of neonatal causes of death (Liu et al. 2012) .
Figure 3. Preterm births by gestational age and region forthe year 2010. Based on Millennium Development Goal regions. Source:
Reproducedwith permission from Blencowe et al. (2012) National, regional and worldwideestimates of preterm birth rates in the year 2010 with
timetrends since 1990 for selected countries: a systematic analysis andimplications. Lancet 379(9832): 2162-2172.
Lancet.2013 January 19; 381(9862): 223–234.
Overview of defi nitions for preterm birth and relatedpregnancy outcomes. Source: Reproduced with permission from Blencowe
etal. (2012) National, regional and worldwide estimates of preterm birth rates inthe year 2010 with time trends since 1990 for selected countries: a systematicanalysis and implications. Lancet 379(9832): 2162-2172.
The history of neonatal care in the United Kingdom and theUnited States shows that dramatic declines in neonatal mortality are possibleeven before neonatal intensive care is scaled up. Source: Born TooSoon, Chapter 5 [113]. Acroynms used: ANCS = antenatal
Programopportunities for scale up of the care
专业规模发展将带来空间提升
早产对幸存者的长期影响
Figure 1. 135 million newborns and 15 million prematurebabies-health system needs and human capital outcomes around the year
2010. Source: Born Too Soon report, chapter 5 [113].Analysis using data from Blencowe et al., 2012 [1]; Cousens et al., 2011 [114];Liu et al., 2012 [8].Program opportunities for scale up of care
专业规模发展将带来提升空间
许多大覆盖的早产儿数据缺乏, 无法为提升干预水平提供基础证据, 包括高收入的国家, 故很难评估全球早产儿管理状况或几个重要新生儿干预项目实施情况
Nationalcoverage data for many of the evidence-based interventions for premature babiesare lacking even in high-income settings, hence it is difficult to assess theglobal situation for care of premature babies or indeed for several importantnewborn care interventions
Reprod Health. 2013;10(Suppl 1): S5.
Missed opportunities to reach pretermbabies with essential interventions, median for Countdown to 2015 prioritycountries.
Source: Born Too Soon, Chapter 5 . Data sources: Adapted (Kinney et al., 2010) using data from UNICEF Global Databases ...
What shuold we do next
赢得机遇推动早产与早产儿医学发展
推动与发展策略
早产管理:监测与预警, 预防与治疗
提高早产儿复苏水平
建立等级技术平台, 提升不同重症监护病房技术水平
加强早产儿入院前与出院后管理
架构家长教育体系, 达成社会共识
Lawnet al.Reproductive Health 2013,10(Suppl 1):S5
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