Mother's Own Milk and its Relationship to Growth and Morbidity in a Population-Based Cohort of Extremely Preterm Infants

ObjectiveTo compare mortality and rates of significant neurosensory impairment (sNSI) at 18–36 months’ corrected age in infants born extremely preterm across three international cohorts.DesignRetrospective analysis of prospectively collected neonatal and follow-up data.SettingThree population-based observational cohort studies: the Australian and New Zealand Neonatal Network (ANZNN), the Canadian Neonatal and Follow-up Networks (CNN/CNFUN) and the French cohort Etude (Epidémiologique sur les Petits Ages Gestationnels: EPIPAGE-2).PatientsExtremely preterm neonates of <28 weeks’ gestation in year 2011.Main outcome measuresPrimary outcome was composite of mortality or sNSI defined by cerebral palsy with no independent walking, disabling hearing loss and bilateral blindness.ResultsOverall, 3055 infants (ANZNN n=960, CNN/CNFUN n=1019, EPIPAGE-2 n=1076) were included in the study. Primary composite outcome rates were 21.3%, 20.6% and 28.4%; mortality rates were 18.7%, 17.4% and 26.3%; and rates of sNSI among survivors were 4.3%, 5.3% and 3.3% for ANZNN, CNN/CNFUN and EPIPAGE-2, respectively. Adjusted for gestational age and multiple births, EPIPAGE-2 had higher odds of composite outcome compared with ANZNN (OR 1.71, 95% CI 1.38 to 2.13) and CNN/CNFUN (OR 1.72, 95% CI 1.39 to 2.12). EPIPAGE-2 did have a trend of lower odds of sNDI but far short of compensating for the significant increase in mortality odds. These differences may be related to variations in perinatal approach and practices (and not to differences in infants’ baseline characteristics).ConclusionsComposite outcome of mortality or sNSI for extremely preterm infants differed across high-income countries with similar baseline characteristics and access to healthcare.

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O-123 Intakes Of Micronutrients Is Associated With Early Growth In Extremely Preterm Infants – A Population-based Study

Archives of Disease in Childhood ◽

10.1136/archdischild-2014-307384.190 ◽

2014 ◽

Vol 99 (Suppl 2) ◽

pp. A72.1-A72

Author(s):

E Stoltz Sjöström ◽

I Öhlund ◽

F Ahlsson ◽

M Domellöf

Keyword(s):

Preterm Infants ◽

Population Based ◽

Early Growth ◽

Population Based Study ◽

Extremely Preterm ◽

Extremely Preterm Infants

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Single-centre vs. population-based outcome data of extremely preterm infants at the limits of viability

Acta Paediatrica ◽

10.1111/j.1651-2227.2009.01393.x ◽

2009 ◽

Vol 98 (9) ◽

pp. 1451-1455 ◽

Cited By ~ 26

Author(s):

Patrizia Kutz ◽

Sandra Horsch ◽

Lisa Kühn ◽

Claudia Roll

Keyword(s):

Preterm Infants ◽

Population Based ◽

Outcome Data ◽

Single Centre ◽

Extremely Preterm ◽

Extremely Preterm Infants ◽

Limits Of Viability

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Global incidence of intraventricular hemorrhage among extremely preterm infants: a systematic literature review

Journal of Perinatal Medicine ◽

10.1515/jpm-2020-0331 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Csaba Siffel ◽

Kristin D. Kistler ◽

Sujata P. Sarda

Keyword(s):

North America ◽

Literature Review ◽

Preterm Infants ◽

Systematic Literature Review ◽

Gestational Age ◽

Intraventricular Hemorrhage ◽

Population Based ◽

Extremely Preterm ◽

Extremely Preterm Infants ◽

Grade 3

Abstract Objectives To conduct a systematic literature review to evaluate the global incidence of intraventricular hemorrhage grade 2–4 among extremely preterm infants. Methods We performed searches in MEDLINE and Embase for intraventricular hemorrhage and prematurity cited in English language observational studies published from May 2006 to October 2017. Included studies analyzed data from infants born at ≤28 weeks’ gestational age and reported on intraventricular hemorrhage epidemiology. Results Ninety-eight eligible studies encompassed 39 articles from Europe, 31 from North America, 25 from Asia, five from Oceania, and none from Africa or South America; both Europe and North America were included in two publications. The reported global incidence range of intraventricular hemorrhage grade 3–4 was 5–52% (Europe: 5–52%; North America: 8–22%; Asia: 5–36%; Oceania: 8–13%). When only population-based studies were included, the incidence range of intraventricular hemorrhage grade 3–4 was 6–22%. The incidence range of intraventricular hemorrhage grade 2 was infrequently documented and ranged from 5–19% (including population-based studies). The incidence of intraventricular hemorrhage was generally inversely related to gestational age. Conclusions Intraventricular hemorrhage is a frequent complication of extremely preterm birth. Intraventricular hemorrhage incidence range varies by region, and the global incidence of intraventricular hemorrhage grade 2 is not well documented.

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Preterm Morbidity and Mortality by Gestational Age. A Birth Population-Based Study

10.21203/rs.3.rs-61695/v1 ◽

2020 ◽

Author(s):

Bo Sun ◽

Xiaojing Guo ◽

Xiaoqiong Li ◽

Tingting Qi ◽

Zhaojun Pan ◽

...

Keyword(s):

Preterm Infants ◽

Gestational Age ◽

Death Rate ◽

Preterm Births ◽

Population Based ◽

Morbidity And Mortality ◽

Preterm Neonates ◽

Hospital Death ◽

Extremely Preterm ◽

Extremely Preterm Infants

Abstract Background: Despite 15-17 million of annual births in China, there is a paucity of information on preterm morbidity and mortality. We characterized the outcome of preterm births and hospitalized preterm infants by gestational age (GA) in Huai’an in 2015, an emerging prefectural region of China.Methods: Of 59,245 regional total births, clinical data on 2,651 preterm births and 1,941 hospitalized preterm neonates were extracted from Huai’an Women and Children’s Hospital (HWCH) and non-HWCH hospitals in 2018-2020. Preterm morbidity and mortality rates were characterized and compared by hospital categories and GA spectra. Death risks of preterm births and hospitalized preterm infants in the whole region were analyzed with multivariable logistic regression.Results: The incidences of extreme, very, moderate, late and total preterm of the regional total births were 1.4, 5.3, 7.2, 30.8 and 44.7‰, with all-death rates being 1.0, 1.6, 0.6, 1.1 and 4.3‰, respectively, of the regional total births. There were 1,025 (52.8% of whole region) preterm admissions in HWCH, with significantly lower in-hospital death rate of inborn (33/802) than out-born (23/223) infants. Compared to non-HWCH, four-fold more neonates in HWCH were under critical care with higher death rate, including most extremely preterm infants. Significant all-death risks were found for the total preterm births in BW < 1,000g, II-III degree of amniotic fluid contamination, Apgar-5 min < 7, and birth defects (BD). For the hospitalized preterm infants, significant in-hospital death risks were found in out-born of HWCH, GA < 32 weeks, Apgar-5 min < 7, BD, necrotizing enterocolitis and ventilation, whereas born in HWCH, antenatal glucocorticoids, cesarean delivery and surfactant use were protective factors against death.Conclusions: The integrated data revealed GA-specific morbidity and mortality on the basis of total preterm births and their hospitalization, demonstrating the efficacy of leading referral center and whole regional perinatal-neonatal network in China. The concept and protocol of our current study should be extended to gain comprehensive understanding in the world-wide campaign for prevention of preterm birth.

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