目的 探索超早产儿（EPI）死亡的相关危险因素。方法 回顾性分析2018年1月1日至2021年12月31日新生儿科住院的EPI的临床资料。患儿根据出院时临床结局分为存活组和死亡组，比较两组间临床特征，分析EPI死亡的危险因素。结果 共纳入114例EPI，其中男58例、女56例，中位胎龄27.0（26.0~27.6）周，平均出生体重（921±179）g，死亡24例（21.1%）。两组患儿母亲之间高龄、宫颈机能不全、合并妊娠期糖尿病、胎膜早破、产前使用糖皮质激素、产前使用抗生素比例差异均无统计学意义（P>0.05）。多因素logistic回归分析显示出生体重≤750 g、严重新生儿呼吸窘迫综合征、生后1周内肺出血、生后1周内使用胰岛素、感染性休克是EPI死亡的独立危险因素（P<0.05）。结论 出生体重≤750 g，合并严重新生儿呼吸窘迫综合征、感染性休克，生后1周内肺出血、使用胰岛素的EPI死亡风险更高。

Objective To investigate the risk factors of death in extremely preterm infants (EPI). Methods The clinical data of EPI hospitalized in the neonatology department from January 1, 2018 to December 31, 2021 were retrospectively analyzed. According to the clinical outcome at the time of discharge, the patients were divided into the survival group and the death group, and the clinical characteristics between the two groups were compared to analyze the risk factors of EPI death. Results A total of 114 EPI patients (58 boys and 56 girls) were included. The median gestational age was 27.0 (26.0-27.6) weeks, the mean birth weight was (921±179) g, and 24 (21.1%) died. There were no significant differences in the proportions of advanced maternal age, cervical insufficiency, gestational diabetes mellitus, premature rupture of membranes, prenatal use of glucocorticoids and antibiotics between the two groups (P>0.05). Multivariate logistic regression analysis showed that birth weight ≤750g, severe neonatal respiratory distress syndrome, pulmonary hemorrhage within 1 week after birth, insulin use within 1 week after birth, and septic shock were independent risk factors for EPI death (P<0.05). Conclusions Body weight ≤750g, severe neonatal respiratory distress syndrome, septic shock, and pulmonary hemorrhage within 1 week after birth, or insulin use within 1 week after birth have a higher death risk in EPI.