scholarly journals Survival and causes of death in extremely preterm infants in the Netherlands

2020 ◽  
pp. fetalneonatal-2020-318978
Author(s):  
Pauline van Beek ◽  
Floris Groenendaal ◽  
Lisa Broeders ◽  
Peter H Dijk ◽  
Koen P Dijkman ◽  
...  
Keyword(s):  
The Netherlands ◽  
Cause Of Death ◽  
Respiratory Insufficiency ◽  
Guideline Implementation ◽  
Admission Rate ◽  
Necrotising Enterocolitis ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
The Impact ◽  
Timing Of Death

ObjectiveIn the Netherlands, the threshold for offering active treatment for spontaneous birth was lowered from 25+0 to 24+0 weeks’ gestation in 2010. This study aimed to evaluate the impact of guideline implementation on survival and causes and timing of death in the years following implementation.DesignNational cohort study, using data from the Netherlands Perinatal Registry.PatientsThe study population included all 3312 stillborn and live born infants with a gestational age (GA) between 240/7 and 266/7 weeks born between January 2011 and December 2017. Infants with the same GA born between January 2007 and December 2009 (N=1400) were used as the reference group.Main outcome measuresSurvival to discharge, as well as cause and timing of death.ResultsAfter guideline implementation, there was a significant increase in neonatal intensive care unit (NICU) admission rate for live born infants born at 24 weeks’ GA (27%–69%, p<0.001), resulting in increased survival to discharge in 24-week live born infants (13%–34%, p<0.001). Top three causes of in-hospital mortality were necrotising enterocolitis (28%), respiratory distress syndrome (19%) and intraventricular haemorrhage (17%). A significant decrease in cause of death either complicated or caused by respiratory insufficiency was seen over time (34% in 2011–2014 to 23% in 2015–2017, p=0.006).ConclusionsImplementation of the 2010 guideline resulted as expected in increased NICU admissions rate and postnatal survival of infants born at 24 weeks’ GA. In the years after implementation, a shift in cause of death was seen from respiratory insufficiency towards necrotising enterocolitis and sepsis.

Persistent pulmonary hypertension of the newborn in extremely preterm infants: a Japanese cohort study

2018 ◽  
Vol 103 (6) ◽  
pp. F554-F561 ◽  
Author(s):  
Hidehiko Nakanishi ◽  
Hideyo Suenaga ◽  
Atsushi Uchiyama ◽  
Satoshi Kusuda
Keyword(s):  
Pulmonary Hypertension ◽  
Cohort Study ◽  
Preterm Infants ◽  
Research Network ◽  
Persistent Pulmonary Hypertension ◽  
Neurodevelopmental Outcomes ◽  
Significant Independent Risk Factor ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
The Impact

ObjectiveTo investigate the characteristics of persistent pulmonary hypertension of the newborn (PPHN) in extremely preterm infants and its impact on neurodevelopmental outcomes at 3 years of age.DesignA retrospective multicentre cohort study.Settings202 tertiary perinatal centres registered in the Neonatal Research Network of Japan (NRNJ).PatientsInfants born at <28 weeks of gestational age (GA), between 2003 and 2012, were extracted from tertiary perinatal centres participating in NRNJ.Main outcome measuresDemographic characteristics, morbidity, interventions and mortality were compared for infants with and without PPHN. Multivariable logistic analysis was performed to evaluate the impact of PPHN on long-term neurodevelopmental outcomes (the prevalence rate of cerebral palsy, need for home oxygen therapy, and visual, hearing and cognitive impairment) at 3 years of age.ResultsThe prevalence of PPHN among the 12 954 extremely preterm infants enrolled was 8.1% (95% CI 7.7% to 8.6%), with the trend increasing annually, and a higher proportion as GA decreased: 18.5% (range, 15.2% to 22.4%) for infants born at 22 weeks compared with 4.4% (range, 3.8% to 5.2%) for those born at 27 weeks. Clinical chorioamnionitis and premature rupture of membranes were associated with PPHN. On multivariate analysis of the data from 5923 infants followed up for 3 years, PPHN was a significant independent risk factor for visual impairment (adjusted OR, 1.42, 95% CI 1.03 to 1.97).ConclusionsThe prevalence of PPHN in extremely preterm infants has been increasing over the past decade in Japan. Clinicians should be aware of visual impairments as a neurodevelopmental abnormality among infants with PPHN.

Changes in perinatal care and survival in very preterm and extremely preterm infants in The Netherlands between 1983 and 1995

2004 ◽  
Vol 112 (2) ◽  
pp. 170-177 ◽  
Author(s):  
Sabine Anthony ◽  
Lya den Ouden ◽  
Ronald Brand ◽  
Pauline Verloove-Vanhorick ◽  
Jack Bennebroek Gravenhorst
Keyword(s):  
The Netherlands ◽  
Preterm Infants ◽  
Perinatal Care ◽  
Very Preterm ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

scholarly journals Follow-Up Examination at the Age of 15 Months of Extremely Preterm Infants after Postnatal Estradiol and Progesterone Replacement

2001 ◽  
Vol 86 (2) ◽  
pp. 601-603 ◽  
Author(s):  
Andreas Trotter ◽  
Birgit Bokelmann ◽  
Wolfgang Sorgo ◽  
Doris Bechinger-Kornhuber ◽  
Hilde Heinemann ◽  
...  
Keyword(s):  
Pilot Study ◽  
Preterm Infants ◽  
Bone Mineralization ◽  
Psychomotor Development ◽  
Control Group ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Developmental Index ◽  
The Impact

A randomized controlled pilot study was performed with a sample of extremely preterm infants to evaluate the impact of postnatal estradiol and progesterone replacement on postnatal bone mineral accretion. Twenty-five of 30 infants in the pilot study survived, and of these, 24 infants were available for the follow-up examination at a median chronological age of 18.1 months (minimum-maximum, 17.0–20.6) corresponding to a corrected age of 14.8 months (minimum-maximum, 12.9–17.4). Somatic growth data and bone mineralization showed no differences between the hormone-treated and control group infants. The deviation of the skeletal age from the corrected age was 0.0 months (minimum-maximum, −7.7 to 7.4) for hormone-treated infants compared with −1.7 months (minimum-maximum, −7.5 to 5.9) for the control group. The Bayley scales mental and psychomotor developmental indexes were 89 (minimum-maximum, 71–107) and 101 (minimum-maximum, 49–121) for the hormone-treated infants and 93 (minimum-maximum, 49–111) and 71 (minimum-maximum, 49–121) for the control group infants, respectively (mental developmental index, P = 1.0; psychomotor developmental index, P = 0.14). The normal psychomotor development in the hormone-treated infants compared with the below average development in the control group infants is encouraging and indicates the potentially important integrative role of sex steroids for the developing brain. Larger studies on the effects of the postnatal replacement of estradiol and progesterone in extremely preterm infants are warranted.

scholarly journals Mortality, Neonatal Morbidity and Two Year Follow-Up of Extremely Preterm Infants Born in the Netherlands in 2007

PLoS ONE ◽  
2012 ◽  
Vol 7 (7) ◽  
pp. e41302 ◽  
Author(s):  
Cornelia G. de Waal ◽  
Nynke Weisglas-Kuperus ◽  
Johannes B. van Goudoever ◽  
Frans J Walther ◽  
◽  
...  
Keyword(s):  
The Netherlands ◽  
Preterm Infants ◽  
Neonatal Morbidity ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

scholarly journals Preventive strategies and factors associated with surgically treated necrotising enterocolitis in extremely preterm infants: an international unit survey linked with retrospective cohort data analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031086 ◽  
Author(s):  
Mark Adams ◽  
Dirk Bassler ◽  
Brian A Darlow ◽  
Kei Lui ◽  
Brian Reichman ◽  
...  
Keyword(s):  
Cohort Study ◽  
New Zealand ◽  
Preterm Infants ◽  
Retrospective Cohort ◽  
Necrotising Enterocolitis ◽  
Preventive Strategies ◽  
Factors Associated ◽  
Cohort Data ◽  
Extremely Preterm ◽  
Extremely Preterm Infants

ObjectivesTo compare necrotising enterocolitis (NEC) prevention practices and NEC associated factors between units from eight countries of the International Network for Evaluation of Outcomes of Neonates, and to assess their association with surgical NEC rates.DesignProspective unit-level survey combined with retrospective cohort study.SettingNeonatal intensive care units in Australia/New Zealand, Canada, Finland, Israel, Spain, Sweden, Switzerland and Tuscany (Italy).PatientsExtremely preterm infants born between 240to 286weeks’ gestation, with birth weights<1500 g, and admitted between 2014–2015.ExposuresNEC prevention practices (probiotics, feeding, donor milk) using responses of an on-line pre-piloted questionnaire containing 10 questions and factors associated with NEC in literature (antenatal steroids, c-section, indomethacin treated patent ductus arteriosus and sepsis) using cohort data.Outcome measuresSurgical NEC rates and death following NEC using cohort data.ResultsThe survey response rate was 91% (153 units). Both probiotic provision and donor milk availability varied between 0%–100% among networks whereas feeding initiation and advancement rates were similar in most networks. The 9792 infants included in the cohort study to link survey results and cohort outcomes, revealed similar baseline characteristics but considerable differences in factors associated with NEC between networks. 397 (4.1%) neonates underwent NEC surgery, ranging from 2.4%–8.4% between networks. Standardised ratios for surgical NEC were lower for Australia/New Zealand, higher for Spain, and comparable for the remaining six networks.ConclusionsThe variation in implementation of NEC prevention practices and in factors associated with NEC in literature could not be associated with the variation in surgical NEC incidence. This corroborates the current lack of consensus surrounding the use of preventive strategies for NEC and emphasises the need for research.

scholarly journals Trends in Overall Mortality, and Timing and Cause of Death among Extremely Preterm Infants near the Limit of Viability

PLoS ONE ◽  
2017 ◽  
Vol 12 (1) ◽  
pp. e0170220 ◽  
Author(s):  
Jae Hyun Park ◽  
Yun Sil Chang ◽  
Sein Sung ◽  
So Yoon Ahn ◽  
Won Soon Park
Keyword(s):  
Preterm Infants ◽  
Cause Of Death ◽  
Extremely Preterm ◽  
Extremely Preterm Infants ◽  
Limit Of Viability ◽  
Overall Mortality
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