756: Compared mortality and morbidity of preterm low birthweight infants born between 1995-2010: a population based study

ObjectiveAfter a decade of increase, the preterm birth (PTB) rate has declined in the USA since 2006, with the largest decline at late preterm (34–36 weeks). We described concomitant changes in gestational age-specific rates of neonatal mortality and morbidity following spontaneous and clinician-initiated PTB among singleton infants.Design, setting and participantsThis retrospective population-based study included 754 763 singleton births in Washington State, USA, 2004–2013, using data from birth certificates and hospitalisation records. PTB subtypes included preterm premature rupture of membranes (PPROM), spontaneous onset of labour and clinician-initiated delivery.Outcome measuresThe primary outcomes were neonatal mortality and a composite outcome including death or severe neonatal morbidity. Temporal trends in the outcomes and individual morbidities were assessed by PTB subtype. Logistic regression yielded adjusted odds ratios (AOR) per 1 year change in outcome and 95% CI.ResultsThe rate of PTB following PPROM and spontaneous labour declined, while clinician-initiated PTB increased (all p<0.01). Overall neonatal mortality remained unchanged (1.3%; AOR 0.99, CI 0.95 to 1.02), though gestational age-specific mortality following clinician-initiated PTB declined at 32–33 weeks (AOR 0.85, CI 0.74 to 0.97) and increased at 34–36 weeks (AOR 1.10, CI 1.01 to 1.20). The overall rate of the composite outcome increased (from 7.9% to 11.9%; AOR 1.06, CI 1.05 to 1.08). Among late preterm infants, combined mortality or severe morbidity increased following PPROM (AOR 1.13, CI 1.08 to 1.18), spontaneous labour (AOR 1.09, CI 1.06 to 1.13) and clinician-initiated delivery (AOR 1.10, CI 1.07 to 1.13). Neonatal sepsis rates increased among all preterm infants (AOR 1.09, CI 1.08 to 1.11).ConclusionsTiming of obstetric interventions is associated with infant health outcomes at preterm. The temporal decline in late PTB among singleton infants was associated with increased mortality among late preterm infants born following clinician-initiated delivery and increased combined mortality or severe morbidity among all late preterm infants, mainly due to increased rate of sepsis.

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Disabilities and health of extremely low-birthweight teenagers: a population-based study

Acta Paediatrica ◽

10.1111/j.1651-2227.2011.02576.x ◽

2012 ◽

Vol 101 (5) ◽

pp. 518-523 ◽

Cited By ~ 9

Author(s):

Ingibjorg Georgsdottir ◽

Gigja Erlingsdottir ◽

Birgir Hrafnkelsson ◽

Asgeir Haraldsson ◽

Atli Dagbjartsson

Keyword(s):

Low Birthweight ◽

Population Based ◽

Population Based Study ◽

Extremely Low Birthweight

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Very low-birth-weight-infants conceived by in vitro fertilization are not at higher risk for mortality and morbidity: a population-based study

Fertility and Sterility ◽

10.1016/j.fertnstert.2005.09.050 ◽

2006 ◽

Vol 85 (4) ◽

pp. 907-912 ◽

Cited By ~ 15

Author(s):

Michael S. Schimmel ◽

Cathy Hammerman ◽

Ayala Lusky ◽

Brian Reichman

Keyword(s):

Birth Weight ◽

In Vitro Fertilization ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Population Based ◽

Low Birth Weight Infants ◽

Population Based Study ◽

Vitro Fertilization ◽

Mortality And Morbidity

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Mortality and morbidity in preterm small-for-gestational-age infants: a population-based study

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2011.08.025 ◽

2012 ◽

Vol 206 (2) ◽

pp. 150.e1-150.e7 ◽

Cited By ~ 54

Author(s):

Sorina Grisaru-Granovsky ◽

Brian Reichman ◽

Liat Lerner-Geva ◽

Valentina Boyko ◽

Cathy Hammerman ◽

...

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Population Based ◽

Population Based Study ◽

Mortality And Morbidity

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Mortality and morbidity of neonates born at <26 weeks of gestation (1998–2003). A population-based study

Journal of Perinatal Medicine ◽

10.1515/jpm.2008.016 ◽

2008 ◽

Vol 36 (2) ◽

Cited By ~ 8

Author(s):

Eva Landmann ◽

Björn Misselwitz ◽

Jens O. Steiss ◽

Ludwig Gortner

Keyword(s):

Population Based ◽

Population Based Study ◽

Mortality And Morbidity

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Mortality and Morbidity among Farmers, Nonfarming Rural Men, and Urban Referents: A Prospective Population-Based Study

International Journal of Occupational and Environmental Health ◽

10.1179/oeh.2009.15.1.21 ◽

2009 ◽

Vol 15 (1) ◽

pp. 21-28 ◽

Cited By ~ 34

Author(s):

Nils Thelin ◽

Sara Holmberg ◽

Per Nettelbladt ◽

Anders Thelin

Keyword(s):

Population Based ◽

Population Based Study ◽

Mortality And Morbidity

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Excess Mortality and Morbidity in Patients with Craniopharyngioma, Especially in Patients with Childhood Onset: A Population-Based Study in Sweden

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2014-3525 ◽

2015 ◽

Vol 100 (2) ◽

pp. 467-474 ◽

Cited By ~ 70

Author(s):

Daniel S. Olsson ◽

Eva Andersson ◽

Ing-Liss Bryngelsson ◽

Anna G. Nilsson ◽

Gudmundur Johannsson

Keyword(s):

Excess Mortality ◽

Severe Infection ◽

Population Based ◽

Cerebrovascular Diseases ◽

Adult Onset ◽

Inclusion Criteria ◽

Childhood Onset ◽

Population Based Study ◽

Mortality And Morbidity

Abstract Context: Craniopharyngiomas (CPs) in adults have been associated with excess mortality. Objective: The aim of the study was to investigate mortality and morbidity in patients with childhood-onset and adult-onset CP. Methods: Patients with CP were identified and followed in Swedish national health registries, 1987 through 2011. The inclusion criteria for the CP diagnosis were internally validated against patient records in 28% of the study population. Settings: This was a nationwide population-based study. Patients: A total of 307 patients (151 men and 156 women) were identified and included (mean follow-up, 9 years; range, 0–25 years). The inclusion criteria had a positive predictive value of 97% and a sensitivity of 92%. Intervention: There were no interventions. Main Outcome Measures: Standardized mortality ratios (SMRs) and standardized incidence ratios (SIRs) with 95% confidence intervals were calculated using the Swedish population as the reference. Results: During the study, 54 patients died compared with the expected number of 14.1, resulting in an SMR of 3.2 (2.2–4.7) for men and 4.9 (3.2–7.2) for women. Patients with childhood-onset (n = 106) and adult-onset (n = 201) CP had SMRs of 17 (6.3–37) and 3.5 (2.6–4.6), respectively. Patients with hypopituitarism (n = 250), diabetes insipidus (n = 110), and neither of these (n = 54) had SMRs of 4.3 (3.1–5.8), 6.1 (3.5–9.7), and 2.7 (1.4–4.6), respectively. The SMR due to cerebrovascular diseases was 5.1 (1.7–12). SIRs were 5.6 (3.8–8.0) for type 2 diabetes mellitus, 7.1 (5.0–9.9) for cerebral infarction, 0.7 (0.2–1.7) for myocardial infarction, 2.1 (1.4–3.0) for fracture, and 5.9 (3.4–9.4) for severe infection. The SIR for all malignant tumors was 1.3 (0.8–2.1). Conclusions: This first nationwide population-based study of patients with CP demonstrated excess mortality that was especially marked in patients with childhood-onset disease and among women. Death due to cerebrovascular diseases was increased 5-fold. Hypopituitarism and diabetes insipidus were negative prognostic factors for mortality and morbidity. Patients with CP had increased disease burden related to type 2 diabetes mellitus, cerebral infarction, fracture, and severe infection.

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