提高临床对胎龄小于32周早产儿先天性结核病的认知，以提高该病的早期诊断和治疗水平。

回顾性分析东莞市妇幼保健院2023年10月收治的1例27⁺²周超早产儿先天性结核病的临床资料以及诊疗经过。以"先天性结核"为关键词检索万方医学、中国知网以及PubMed数据库1976年1月至2024年12月已发表的相关病例文献，对胎龄小于32周早产儿临床资料进行总结分析。

患儿，男婴，27⁺²周超早产儿，出生后第6天开始反复呼吸暂停、间断发热，经多种抗菌药物治疗无效。生后30 d确诊为先天性结核病，予异烟肼（15 mg·kg^-1·d^-1）、利福平（15 mg·kg^-1·d^-1）和吡嗪酰胺（40 mg·kg^-1·d^-1）抗结核治疗后治愈出院，抗结核疗程6个月。检阅既往文献加之本病例，共纳入胎龄小于32周早产儿先天性结核病病例23例，其中男婴12例，女婴11例；82.6%（19/23）先天性结核病患儿为试管婴儿；死亡病例7例，病死率为30.4%。15.8%（3/19）患儿母亲产前发现结核分枝杆菌（MTB）感染，79%（15/19）患儿母亲产前未发现MTB感染，但产后确诊结核病，5.3%（1/19）患儿母亲产前及产后均未发现MTB感染。胎龄小于32周先天性结核病患儿确诊时间多为出生后1个月左右，常见症状包括呼吸窘迫（11/23、47.8%）、呼吸暂停（10/23、43.5%）、发热（9/23、39.1%）、反应差（3/23、13%）和心动过缓（3/23、13%）等。

胎龄小于32周早产儿先天性结核病病死率高，以试管婴儿常见。临床症状多表现为呼吸窘迫、呼吸暂停、发热、反应差和心动过缓等，若患儿母亲产前或产后确诊结核病，患儿出现上述症状，应尽早对患儿完善结核病相关病原学检查，以早期诊断及抗结核治疗。

To improve the clinical cognition of congenital tuberculosis in preterm infants with gestational age less than 32 weeks, and to improve the early diagnosis and treatment of the disease.

A retrospective analysis was conducted on the clinical data, diagnosis and treatment of a 27⁺² weeks of gestation of premature infant with congenital tuberculosis admitted to Dongguan Maternal and Child Health Care Hospital in October, 2023. A comprehensive search was conducted across Wanfang, CNKI and PubMed databases to identify relevant cases from January, 1976 to December, 2024 through the keyword "congenital tuberculosis", followed by a summary and analysis of all cases involving preterm infants with a gestational age of less than 32 weeks.

The male infant was born at 27⁺² weeks of gestation. At the 6th day after birth, the infant occurred recurrent respiratory apnoea and intermittent fever, which did not respond to multiple courses of antibiotic treatment. At the 30th day after birth, a diagnosis of congenital tuberculosis was identified and the infant was subsequently treated with isoniazid (15 mg·kg^-1·d^-1), rifampicin (15 mg·kg^-1·d^-1) and pyrazinamide (40 mg·kg^-1·d^-1), leading to recovery and discharge. The total course of anti-tuberculosis treatment was 6 months. Review of previous literatures and this case, a total of 23 cases of congenital tuberculosis in preterm infants with a gestational age of less than 32 weeks were identified. Among them, there were 12 male and 11 female infants; 82.6% (19/23) infants with congenital tuberculosis were in vitro fertilization, and 7 infants died, with a mortality rate of 30.4%. There were 15.8% (3/19) mothers of the children were infected with Mycobacterium tuberculosis (MTB) before delivery, 79% (15/19) mothers were not infected with MTB before delivery, but tuberculosis was diagnosed after delivery; and 5.3% (1/19) mothers were not infected with MTB before and after delivery. Children with congenital tuberculosis whose gestational age less than 32 weeks were mostly diagnosed about 1 month after birth. Common symptoms included respiratory distress (11/23, 47.8%), apnea (10/23, 43.5%), fever (9/23, 39.1%), poor response (3/23, 13%) and bradycardia (3/23, 13%).

Premature infants with gestational age less than 32 weeks have a high mortality rate of congenital tuberculosis, which is common in in vitro fertilization infants. The clinical symptoms are mostly respiratory distress, apnea, fever, poor response and bradycardia. If the mother was diagnosed with tuberculosis before or after childbirth and the child had the above symptoms, it is necessary to improve the pathogenic examination related to tuberculosis for early diagnosis and anti-tuberculosis treatment.