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Wide variation in severe neonatal morbidity among very preterm infants in European regions
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Effective Perinatal Intensive Care in Europe (EPICE) Research Group (Including: Bonamy, A. K., Zeitlin, J., Piedvache, A., Maier, R. F., van Heijst, A., Varendi, H., Manktelow, B., Fenton, A., Mazela, J., Cuttini, M., Norman, M., Petrou, Stavros, Van Reempts, P., Barros, H. and Draper, E. S.). (2018) Wide variation in severe neonatal morbidity among very preterm infants in European regions. Archives of Disease in Childhood, 104 (1). F36-F45. doi:10.1136/archdischild-2017-313697
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WRAP-wide-variation-severe-neonatal-morbidity-among-preterm-infants-European-regions-Petrou-2018.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons: Attribution-Noncommercial 4.0. Download (392Kb) | Preview |
Official URL: http://dx.doi.org/10.1136/archdischild-2017-313697
Abstract
Objective To investigate the variation in severe neonatal morbidity among very preterm (VPT) infants across European regions and whether morbidity rates are higher in regions with low compared with high mortality rates.
Design Area-based cohort study of all births before 32 weeks of gestational age.
Setting 16 regions in 11 European countries in 2011/2012.
Patients Survivors to discharge from neonatal care (n=6422).
Main outcome measures Severe neonatal morbidity was defined as intraventricular haemorrhage grades III and IV, cystic periventricular leukomalacia, surgical necrotizing enterocolitis and retinopathy of prematurity grades ≥3. A secondary outcome included severe bronchopulmonary dysplasia (BPD), data available in 14 regions. Common definitions for neonatal morbidities were established before data abstraction from medical records. Regional severe neonatal morbidity rates were correlated with regional in-hospital mortality rates for live births after adjustment on maternal and neonatal characteristics.
Results 10.6% of survivors had a severe neonatal morbidity without severe BPD (regional range 6.4%–23.5%) and 13.8% including severe BPD (regional range 10.0%–23.5%). Adjusted inhospital mortality was 13.7% (regional range 8.4%–18.8%). Differences between regions remained significant after consideration of maternal and neonatal characteristics (P<0.001) and severe neonatal morbidity rates were not correlated with mortality rates (P=0.50).
Conclusion Severe neonatal morbidity rates for VPT survivors varied widely across European regions and were independent of mortality rates.
| Item Type: | Journal Article | |||||||||||||||||||||
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| Subjects: | R Medicine > RG Gynecology and obstetrics R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services |
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| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences > Clinical Trials Unit Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Newborn infants--Death, Newborn infants--Mortality--Europe, Perinatal death--Europe, Premature infants--Europe | |||||||||||||||||||||
| Journal or Publication Title: | Archives of Disease in Childhood | |||||||||||||||||||||
| Publisher: | BMJ | |||||||||||||||||||||
| ISSN: | 0003-9888 | |||||||||||||||||||||
| Official Date: | 20 January 2018 | |||||||||||||||||||||
| Dates: |
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| Date of first compliant deposit: | 28 November 2017 | |||||||||||||||||||||
| Volume: | 104 | |||||||||||||||||||||
| Number: | 1 | |||||||||||||||||||||
| Page Range: | F36-F45 | |||||||||||||||||||||
| DOI: | 10.1136/archdischild-2017-313697 | |||||||||||||||||||||
| Status: | Peer Reviewed | |||||||||||||||||||||
| Publication Status: | Published | |||||||||||||||||||||
| Access rights to Published version: | Open Access | |||||||||||||||||||||
| Funder: | Neonatal Networks for East Midlands and Yorkshire and Humber regions | |||||||||||||||||||||
| RIOXX Funder/Project Grant: |
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