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Active perinatal care of preterm infants in the German Neonatal Network.
Humberg, Alexander; Härtel, Christoph; Rausch, Tanja K; Stichtenoth, Guido; Jung, Philipp; Wieg, Christian; Kribs, Angela; von der Wense, Axel; Weller, Ursula; Höhn, Thomas; Olbertz, Dirk M; Felderhoff-Müser, Ursula; Rossi, Rainer; Teig, Norbert; Heitmann, Friedhelm; Schmidtke, Susanne; Bohnhorst, Bettina; Vochem, Matthias; Segerer, Hugo; Möller, Jens; Eichhorn, Joachim G; Wintgens, Jürgen; Böttger, Ralf; Hubert, Mechthild; Dördelmann, Michael; Hillebrand, Georg; Roll, Claudia; Jensen, Reinhard; Zemlin, Michael; Mögel, Michael; Werner, Claudius; Schäfer, Stefan; Schaible, Thomas; Franz, Axel; Heldmann, Michael; Ehlers, Silke; Kannt, Olaf; Orlikowsky, Thorsten; Gerleve, Hubert; Schneider, Katja; Haase, Roland; Böckenholt, Kai; Linnemann, Knud; Herting, Egbert; Göpel, Wolfgang.
Affiliation
  • Humberg A; Paediatrics, University of Lübeck, Lübeck, Germany.
  • Härtel C; Paediatrics, University of Lübeck, Lübeck, Germany.
  • Rausch TK; Institute for Medical Biometry and Statistics Lübeck, Lübeck, Germany.
  • Stichtenoth G; Paediatrics, University of Lübeck, Lübeck, Germany.
  • Jung P; Pediatrics, University Hospital Schleswig-Holstein, Lübeck, Germany.
  • Wieg C; Children's Hospital Aschaffenburg-Alzenau, Aschaffenburg, Germany.
  • Kribs A; Neonatology and Pediatric Intensive Care, University Hospital of Cologne, Cologne, Germany.
  • von der Wense A; Department of Neonatology, Children's Hospital Hamburg-Altona, Hamburg, Germany.
  • Weller U; Department of Paediatrics, Evangelical Klinikum Bethel, Bielefeld, Germany.
  • Höhn T; Department of Paediatrics, University of Düsseldorf, Düsseldorf, Germany.
  • Olbertz DM; Department of Neonatology, Klinikum Südstadt Rostock, Rostock, Germany.
  • Felderhoff-Müser U; Department of Neonatology, University Hospital of Essen, Essen, Germany.
  • Rossi R; Vivantes Klinikum Neukölln, Berlin, Germany.
  • Teig N; Paediatrics, University Hospital, Bochum, Germany.
  • Heitmann F; Department of Paediatrics, Klinikum Dortmund, Dortmund, Germany.
  • Schmidtke S; Department of Neonatology, Asklepios Hospital Hamburg-Barmbek, Hamburg-Barmbek, Germany.
  • Bohnhorst B; Pediatric Pulmonology and Neonatology, Hannover Medical School, Hannover, Germany.
  • Vochem M; Department of Neonatology, Olgahospital Stuttgart, Stuttgart, Germany.
  • Segerer H; Neonatology, Krankenhaus Barmherzige Brüder, Regensburg, Germany.
  • Möller J; Department of Paediatrics, Saarbrücken General Hospital, Saarbrücken, Germany.
  • Eichhorn JG; Department of Paediatrics, Klinikum Leverkusen gGmbH, Leverkusen, Germany.
  • Wintgens J; Department of Paediatrics, Hospital Mönchengladbach, Mönchengladbach, Germany.
  • Böttger R; Department of Neonatology, Universitatsklinikum Magdeburg, Magdeburg, Germany.
  • Hubert M; Department of Neonatology and Pediatric Intensive Care, DRK Children's Hospital, Siegen, Germany.
  • Dördelmann M; Department of Paediatrics, Diakonissen Hospital Flensburg, Flensburg, Germany.
  • Hillebrand G; Department of Paediatrics, Hospital Itzehoe, Itzehoe, Germany.
  • Roll C; Neonatology and Paediatric Intensive Care, Vest Children's Hospital Datteln, University Witten-Herdecke, Datteln, Germany.
  • Jensen R; Department of Paediatrics, Westküstenklinikum Heide, Heide, Germany.
  • Zemlin M; General Pediatrics and Neonatology, Saarland University, Homburg/Saar, Germany.
  • Mögel M; Department of Neonatology and Pediatric Intensive Care, University Hospital Carl Gustav Carus, Dresden, Germany.
  • Werner C; Department of Paediatrics, University of Münster, Münster, Germany.
  • Schäfer S; Children's Hospital (Städtisches Klinikum) Nürnberg, Nürnberg, Germany.
  • Schaible T; Department of Paediatrics, University Medical Center Mannheim, Mannheim, Germany.
  • Franz A; Neonatology, University of Tübingen, Tübingen, Germany.
  • Heldmann M; HELIOS Children's Hospital Wuppertal, Witten/Herdecke University, Wuppertal, Germany.
  • Ehlers S; Department of Neonatology, Bürgerhospital Frankfurt, Frankfurt, Germany.
  • Kannt O; Helios Klinik Schwerin, Schwerin, Germany.
  • Orlikowsky T; Neonatology, University of Aachen, Aachen, Germany.
  • Gerleve H; Department of Paediatrics, Christophorus Kliniken Coesfeld, Coesfeld, Germany.
  • Schneider K; Department of Paediatrics, GFO Hospitals Bonn, Bonn, Germany.
  • Haase R; Children's Hospital, University of Halle, Halle/Saale, Germany.
  • Böckenholt K; Children's Hospital of the City of Cologne, Köln, Germany.
  • Linnemann K; Department of Paediatrics, University of Greifswald, Greifswald, Germany.
  • Herting E; Paediatrics, University of Lübeck, Lübeck, Germany.
  • Göpel W; Paediatrics, University of Lübeck, Lübeck, Germany.
Arch Dis Child Fetal Neonatal Ed ; 105(2): 190-195, 2020 Mar.
Article in En | MEDLINE | ID: mdl-31248963
ABSTRACT

OBJECTIVE:

To determine if survival rates of preterm infants receiving active perinatal care improve over time.

DESIGN:

The German Neonatal Network is a cohort study of preterm infants with birth weight <1500 g. All eligible infants receiving active perinatal care are registered. We analysed data of patients discharged between 2011 and 2016.

SETTING:

43 German level III neonatal intensive care units (NICUs). PATIENTS 8222 preterm infants with a gestational age between 22/0 and 28/6 weeks who received active perinatal care.

INTERVENTIONS:

Participating NICUs were grouped according to their specific survival rate from 2011 to 2013 to high (percentile >P75), intermediate (P25-P75) and low (survival. We compared these survival rates with data in 2014-2016. MAIN OUTCOME

MEASURES:

Death by any cause before discharge.

RESULTS:

Total survival increased from 85.8% in 2011-2013 to 87.4% in 2014-2016. This increase was due to reduced mortality of NICUs with low survival rates in 2011-2013. Survival increased in these centres from 53% to 64% in the 22-24 weeks strata and from 73% to 84% in the 25-26 weeks strata.

CONCLUSIONS:

Our data support previous reports that active perinatal care of very immature infants improves outcomes at the border of viability and survival rates at higher gestational ages. The high total number of surviving infants below 24 weeks of gestation challenges national recommendations exclusively referring to gestational age as the single criterion for providing active care. However, more data are needed before recommendations for parental counselling should be reconsidered. TRIAL REGISTRATION Approval by the local institutional review board for research in human subjects of the University of Lübeck (file number 08-022) and by the local ethic committees of all participating centres has been given.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Intensive Care Units, Neonatal / Perinatal Care / Perinatal Mortality / Infant, Extremely Premature Type of study: Clinical_trials / Etiology_studies / Observational_studies / Risk_factors_studies Aspects: Ethics / Patient_preference Limits: Female / Humans / Infant / Male / Newborn Language: En Journal: Arch Dis Child Fetal Neonatal Ed Journal subject: PEDIATRIA / PERINATOLOGIA Year: 2020 Document type: Article Affiliation country: Germany
Fulltext
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Intensive Care Units, Neonatal / Perinatal Care / Perinatal Mortality / Infant, Extremely Premature Type of study: Clinical_trials / Etiology_studies / Observational_studies / Risk_factors_studies Aspects: Ethics / Patient_preference Limits: Female / Humans / Infant / Male / Newborn Language: En Journal: Arch Dis Child Fetal Neonatal Ed Journal subject: PEDIATRIA / PERINATOLOGIA Year: 2020 Document type: Article Affiliation country: Germany