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Trends in Outcomes for Neonates Born Very Preterm and Very Low Birth Weight in 11 High-Income Countries


Lui, Kei; Lee, Shoo K; Kusuda, Satoshi; Adams, Mark; Vento, Maximo; Reichman, Brian; Darlow, Brian A; Lehtonen, Liisa; Modi, Neena; Norman, Mikael; Håkansson, Stellan; Bassler, Dirk; Rusconi, Franca; Lodha, Abhay; Yang, Junmin; Shah, Prakesh S (2019). Trends in Outcomes for Neonates Born Very Preterm and Very Low Birth Weight in 11 High-Income Countries. Journal of Pediatrics, 215:32-40.e14.

Abstract

OBJECTIVE To evaluate outcome trends of neonates born very preterm in 11 high-income countries participating in the International Network for Evaluating Outcomes of neonates.
STUDY DESIGN In a retrospective cohort study, we included 154 233 neonates admitted to 529 neonatal units between January 1, 2007, and December 31, 2015, at 24$^{0/7}$ to 31$^{6/7}$ weeks of gestational age and birth weight <1500 g. Composite outcomes were in-hospital mortality or any of severe neurologic injury, treated retinopathy of prematurity, and bronchopulmonary dysplasia (BPD); and same composite outcome excluding BPD. Secondary outcomes were mortality and individual morbidities. For each country, annual outcome trends and adjusted relative risks comparing epoch 2 (2012-2015) to epoch 1 (2007-2011) were analyzed.
RESULTS For composite outcome including BPD, the trend decreased in Canada and Israel but increased in Australia and New Zealand, Japan, Spain, Sweden, and the United Kingdom. For composite outcome excluding BPD, the trend decreased in all countries except Spain, Sweden, Tuscany, and the United Kingdom. The risk of composite outcome was lower in epoch 2 than epoch 1 in Canada (adjusted relative risks 0.78; 95% CI 0.74-0.82) only. The risk of composite outcome excluding BPD was significantly lower in epoch 2 compared with epoch 1 in Australia and New Zealand, Canada, Finland, Japan, and Switzerland. Mortality rates reduced in most countries in epoch 2. BPD rates increased significantly in all countries except Canada, Israel, Finland, and Tuscany.
CONCLUSIONS In most countries, mortality decreased whereas BPD increased for neonates born very preterm.

Abstract

OBJECTIVE To evaluate outcome trends of neonates born very preterm in 11 high-income countries participating in the International Network for Evaluating Outcomes of neonates.
STUDY DESIGN In a retrospective cohort study, we included 154 233 neonates admitted to 529 neonatal units between January 1, 2007, and December 31, 2015, at 24$^{0/7}$ to 31$^{6/7}$ weeks of gestational age and birth weight <1500 g. Composite outcomes were in-hospital mortality or any of severe neurologic injury, treated retinopathy of prematurity, and bronchopulmonary dysplasia (BPD); and same composite outcome excluding BPD. Secondary outcomes were mortality and individual morbidities. For each country, annual outcome trends and adjusted relative risks comparing epoch 2 (2012-2015) to epoch 1 (2007-2011) were analyzed.
RESULTS For composite outcome including BPD, the trend decreased in Canada and Israel but increased in Australia and New Zealand, Japan, Spain, Sweden, and the United Kingdom. For composite outcome excluding BPD, the trend decreased in all countries except Spain, Sweden, Tuscany, and the United Kingdom. The risk of composite outcome was lower in epoch 2 than epoch 1 in Canada (adjusted relative risks 0.78; 95% CI 0.74-0.82) only. The risk of composite outcome excluding BPD was significantly lower in epoch 2 compared with epoch 1 in Australia and New Zealand, Canada, Finland, Japan, and Switzerland. Mortality rates reduced in most countries in epoch 2. BPD rates increased significantly in all countries except Canada, Israel, Finland, and Tuscany.
CONCLUSIONS In most countries, mortality decreased whereas BPD increased for neonates born very preterm.

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Contributors:International Network for Evaluation of Outcomes of neonates (iNeo)
Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neonatology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:1 December 2019
Deposited On:10 Dec 2019 14:20
Last Modified:11 Dec 2019 02:05
Publisher:Elsevier
ISSN:0022-3476
OA Status:Closed
Publisher DOI:https://doi.org/10.1016/j.jpeds.2019.08.020
PubMed ID:31587861

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