Wide variation in severe neonatal morbidity among very preterm infants in European regions.
Arch Dis Child Fetal Neonatal Ed
; 104(1): F36-F45, 2019 Jan.
Article
em En
| MEDLINE
| ID: mdl-29353260
ABSTRACT
OBJECTIVE:
To investigate the variation in severe neonatal morbidity among very preterm (VPT) infants across European regions and whether morbidity rates are higher in regions with low compared with high mortality rates.DESIGN:
Area-based cohort study of all births before 32 weeks of gestational age.SETTING:
16 regions in 11 European countries in 2011/2012. PATIENTS Survivors to discharge from neonatal care (n=6422). MAIN OUTCOMEMEASURES:
Severe neonatal morbidity was defined as intraventricular haemorrhage grades III and IV, cystic periventricular leukomalacia, surgical necrotizing enterocolitis and retinopathy of prematurity grades ≥3. A secondary outcome included severe bronchopulmonary dysplasia (BPD), data available in 14 regions. Common definitions for neonatal morbidities were established before data abstraction from medical records. Regional severe neonatal morbidity rates were correlated with regional in-hospital mortality rates for live births after adjustment on maternal and neonatal characteristics.RESULTS:
10.6% of survivors had a severe neonatal morbidity without severe BPD (regional range 6.4%-23.5%) and 13.8% including severe BPD (regional range 10.0%-23.5%). Adjusted inhospital mortality was 13.7% (regional range 8.4%-18.8%). Differences between regions remained significant after consideration of maternal and neonatal characteristics (P<0.001) and severe neonatal morbidity rates were not correlated with mortality rates (P=0.50).CONCLUSION:
Severe neonatal morbidity rates for VPT survivors varied widely across European regions and were independent of mortality rates.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Mortalidade Infantil
/
Lactente Extremamente Prematuro
/
Doenças do Prematuro
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Infant
/
Male
/
Newborn
/
Pregnancy
País/Região como assunto:
Europa
Idioma:
En
Revista:
Arch Dis Child Fetal Neonatal Ed
Assunto da revista:
PEDIATRIA
/
PERINATOLOGIA
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Suécia