Outcomes and resource usage of infants born at ≤ 25 weeks gestation in Canada
Author:
Shafey Amy1, Bashir Rani Ameena2, Shah Prakesh13, Synnes Anne4, Yang Junmin3, Kelly Edmond N1, , Shah Prakesh S, Harrison Adele, Synnes Anne, Ting Joseph, Yee Wendy, Aziz Khalid, Toye Jennifer, Fajardo Carlos, Kalapesi Zarin, Sankaran Koravangattu, Daspal Sibasis, Seshia Mary, Alvaro Ruben, Shivananda Sandesh, Da Silva Orlando, Nwaesei Chuks, Lee Kyong-Soon, Dunn Michael, Lemyre Brigitte, Dow Kimberly, Pelausa Ermelinda, Barrington Keith, Drolet Christine, Piedboeuf Bruno, Claveau Martine, Faucher Daniel, Bertelle Valerie, Masse Edith, Canning Roderick, Makary Hala, Ojah Cecil, Monterrosa Luis, Deshpandey Akhil, Afifi Jehier, Kajetanowicz Andrzej, Lee Shoo K, Pillay Thevanisha, Synnes Anne, Sauvé Reg, Hendson Leonora, Reichert Amber, Bodani Jaya, Sankaran Koravangattu, Moddemann Diane, Nwaesei Chuks, Daboval Thierry, Dow Kimberly, Lee David, Ly Linh, Kelly Edmond, el Helou Salhab, Church Paige, Pelausa Ermelinda, Riley Patricia, Levebrve Francine, Demers Charlotte, Bélanger Sylvie, Canning Roderick, Monterrosa Luis, Makary Hala, Vincer Michael, Murphy Phil
Affiliation:
1. Department of Pediatrics, University of Toronto, Toronto, Ontario 2. Department of Pediatrics, the University of Calgary, Calgary, Alberta 3. Maternal-Infant Care Research Center, Mount Sinai Hospital, Toronto, Ontario 4. Department of Pediatrics, University of British Columbia, Vancouver, British Columbia
Abstract
ABSTRACT
Objectives
To determine the outcomes and resource usage of infants born at ≤ 25 weeks gestational age (GA).
Methods
Retrospective study of infants born between April 2009 and September 2011 at ≤ 25 weeks’ GA in all neonatal intensive care units in Canada with follow-up in the neonatal follow-up clinics. Short-term morbidities, neurodevelopmental impairment, significant neurodevelopmental impairment, and resource utilization of infants born at ≤ 24 weeks were compared with neonates born at 25 weeks.
Results
Of 803 neonates discharged alive, 636 (80.4%) infants born at ≤ 25 weeks’ GA were assessed at 18 to 24 months. Caesarean delivery, lower birth weight, and less antenatal steroid exposure were more common in infants born ≤ 24 weeks as compared with 25 weeks. They had significantly higher incidences of ductus arteriosus ligation, severe intracranial hemorrhage, retinopathy of prematurity as well as longer length of stay, central line days, days on respiratory support, days on total parenteral nutrition, days on antibiotics, and need for postnatal steroids. Neurodevelopmental impairment rates were 68.9, 64.5, and 55.6% (P=0.01) and significant neurodevelopmental impairment rates were 39.3, 29.6, and 20.9% (P<0.01) for infants ≤ 23, 24, and 25 weeks GA, respectively. Postdischarge service referrals were higher for those ≤ 23 weeks. Nonsurviving infants born at 25 weeks GA had higher resource utilization during admission than infants born less than 25 weeks.
Conclusions
Adverse outcomes and resource usage were significantly higher among infants born ≤ 24 weeks GA as compared with 25 weeks GA.
Funder
Maternal-Infant Care Research Centre Canadian Institutes of Health Research
Publisher
Oxford University Press (OUP)
Subject
Pediatrics, Perinatology, and Child Health
Cited by
6 articles.
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