Survival in Very Preterm Infants: An International Comparison of 10 National Neonatal Networks

Author:

Helenius Kjell12,Sjörs Gunnar3,Shah Prakesh S.45,Modi Neena6,Reichman Brian7,Morisaki Naho8,Kusuda Satoshi9,Lui Kei10,Darlow Brian A.11,Bassler Dirk12,Håkansson Stellan3,Adams Mark12,Vento Maximo13,Rusconi Franca14,Isayama Tetsuya5,Lee Shoo K.45,Lehtonen Liisa12,

Affiliation:

1. Department of Pediatrics and Adolescent Medicine, Turku University Hospital, Kiinamyllynkatu, Turku, Finland;

2. Department of Clinical Medicine, University of Turku, Turku, Finland;

3. National Quality Registry for Neonatal Care, Department of Pediatrics/Neonatal Services, University Hospital of Umeå, Umeå, Sweden;

4. Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada;

5. Maternal-Infant Care Research Centre, and Department of Pediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada;

6. United Kingdom Neonatal Collaborative, Neonatal Data Analysis Unit, and Section of Neonatal Medicine, Department of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, United Kingdom;

7. Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Israel;

8. Department of Social Medicine, National Center for Child Health and Development, Tokyo, Japan

9. Maternal and Perinatal Center, Tokyo Women’s Medical University, Tokyo, Japan;

10. Royal Hospital for Women, and National Perinatal Epidemiology and Statistics Unit, University of New South Wales, Randwick, Australia;

11. Department of Pediatrics, University of Otago, Christchurch, New Zealand;

12. Department of Neonatology, University Hospital Zurich, University of Zurich, Zurich, Switzerland;

13. Health Research Institute La Fe, Avenida Fernando Abril Martorell, Valencia, Spain; and

14. TIN Toscane Online, Unit of Epidemiology, Meyer Children’s University Hospital, Florence, Italy and Regional Health Agency of Tuscany, Florence, Italy

Abstract

OBJECTIVES: To compare survival rates and age at death among very preterm infants in 10 national and regional neonatal networks. METHODS: A cohort study of very preterm infants, born between 24 and 29 weeks’ gestation and weighing <1500 g, admitted to participating neonatal units between 2007 and 2013 in the International Network for Evaluating Outcomes of Neonates. Survival was compared by using standardized ratios (SRs) comparing survival in each network to the survival estimate of the whole population. RESULTS: Network populations differed with respect to rates of cesarean birth, exposure to antenatal steroids and birth in nontertiary hospitals. Network SRs for survival were highest in Japan (SR: 1.10; 99% confidence interval: 1.08–1.13) and lowest in Spain (SR: 0.88; 99% confidence interval: 0.85–0.90). The overall survival differed from 78% to 93% among networks, the difference being highest at 24 weeks’ gestation (range 35%–84%). Survival rates increased and differences between networks diminished with increasing gestational age (GA) (range 92%–98% at 29 weeks’ gestation); yet, relative differences in survival followed a similar pattern at all GAs. The median age at death varied from 4 days to 13 days across networks. CONCLUSIONS: The network ranking of survival rates for very preterm infants remained largely unchanged as GA increased; however, survival rates showed marked variations at lower GAs. The median age at death also varied among networks. These findings warrant further assessment of the representativeness of the study populations, organization of perinatal services, national guidelines, philosophy of care at extreme GAs, and resources used for decision-making.

Publisher

American Academy of Pediatrics (AAP)

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.7亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2025 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3