Neonatal outcomes of extremely preterm newborns in Czech Neonatal Network
Authors:
J. Smíšek 1; R. Plavka 1*
Authors‘ workplace:
Neonatologické oddělení s JIRP, Gynekologicko-porodnická klinika VFN a 1. LF UK, Praha
1
Published in:
Čes-slov Pediat 2018; 73 (1): 5-9.
Category:
*Česká neonatologická síť
Overview
Introduction and aim of study:
The Czech perinatal care centers created in 2015 the Czech Neonatal Network within the international neonatal network eNewborn. This network is based on the database system into which data on a group of high-risk newborns are entered. The aim of this work was to determine survival and neonatal morbidity in extremely premature neonates born between 22 and 27 gestational weeks in the Czech Republic.
Methods:
Evaluation of individual data from the eNewborn database on mortality and morbidity in newborns with gestational age ≤27+6 from years 2015 and 2016.
Results:
During study period, 728 live births were evaluated in the 22 to 27 gestational weeks. Study group mortality was 23%, ranging from 77% in the 22 gestational week to 4% in the 27 gestational week. At discharge from hospital, 20% of surviving children had a moderate or severe BPD and 8% had a severe retinopathy of prematurity. The combined outcome of a moderate or severe BPD and death rate was 43% across the group, but severity of individual morbidities increased significantly with declining gestational age.
Conclusion:
The nationwide outcomes of a group of extremely preterm newborns point to the heterogeneity of this group where the risk of both death and serious complications is most strongly associated with the decreasing gestational age.
Key words:
extreme prematurity, mortality, morbidity, neonatal outcomes, neonatal network
Sources
1. Jarjour IT. Neurodevelopmental outcome after extreme prematurity: a review of the literature. Pediatr Neurol 2015 Feb; 52 (2): 143–152.
2. O‘Reilly M, Sozo F, Harding R. Impact of preterm birth and bronchopulmonary dysplasia on the developing lung: long-term consequences for respiratory health. Clin Exp Pharmacol Physiol 2013 Nov; 40 (11): 765–773.
3. Koller-Smith LI, Shah PS, Ye XY, et al; Australian and New Zealand Neonatal Network; Canadian Neonatal Network; Swedish Neonatal Quality Register. Comparing very low birth weight versus very low gestation cohort methods for outcome analysis of high risk preterm infants. BMC Pediatr 2017 Jul; 14; 17 (1): 166.
4. Haumont D, NguyenBa C, Modi N, eNewborn. The information technology revolution and challenges for neonatal networks. Neonatology 2017; 111 (4): 388–397.
5. Carlo WA. The high-risk infant. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF (eds). Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier Saunders; 2015: chap 97.
6. Sweet DG, Carnielli V, Greisen G, et al. European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2016 Update. Neonatology 2017; 111 (2): 107–125.
7. McCrea HJ, Ment LR. The diagnosis, management, and postnatal prevention of intraventricular hemorrhage in the preterm neonate. Clin Perinatol 2008; 35: 777–792.
8. Neu J. Necrotizing enterocolitis. World Rev Nutr Diet 2014; 110: 253–263.
9. Bancalari E, Claure N. Definitions and diagnostic criteria for bronchopulmonary dysplasia. Semin Perinatol 2006; 30: 164–170.
10. International Committee for the Classification of Retinopathy of Prematurity. The international classification of retinopathy of prematurity revisited. Arch Ophthalmol 2005; 123: 991–999.
11. Fenton TR, Kim JH. A systematic review and meta-analysis to revise the Fenton growth chart for preterm infants. BMC Pediatr 2013 Apr 20; 13: 59.
12. Marlow N, Bennett C, Draper ES, et al. Perinatal outcomes for extremely preterm babies in relation to place of birth in England: the EPICure 2 study. Arch Dis Child Fetal Neonatal Ed 2014; 99: 181–188.
13. Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network. Pediatrics 2010; 126: 443–456.
14. Ishii N, Kono Y, Yonemoto N, et al. Outcomes of infants born at 22 and 23 weeks‘ gestation. Pediatrics 2013; 132: 62–71.
15. Carlo WA, McDonald SA, Fanaroff AA, et al. Association of antenatal corticosteroids with mortality and neurodevelopmental outcomes among infants born at 22 to 25 weeks‘ gestation. JAMA 2011; 306: 2348–2358.
16. Šimják P, Smíšek J, Koucký M, et al. Proactive approach at the limits of viability improves the short-term outcome of neonates born after 23 weeks‘ gestation. J Perinat Med 2017 Mar 27. pii: /j/jpme.ahead-of-print/jpm-2016-0264/jpm-2016-0264.xml. doi: 10.1515/jpm-2016-0264. [Epub ahead of print] PubMed PMID: 28343176.
17. Larroque B, Breart G, Kaminski M, et al. Survival of very preterm infants: Epipage, a population based cohort study. Arch Dis Child Fetal Neonatal Ed 2004; 89: 139–144.
18. Ancel PY, Goffinet F; EPIPAGE-2 Writing Group, et al. Survival and morbidity of preterm children born at 22 through 34 weeks‘ gestation in France in 2011: results of the EPIPAGE-2 cohort study. JAMA Pediatr 2015 Mar; 169 (3): 230–238. doi: 10.1001/jamapediatrics.2014.3351. Erratum in: JAMA Pediatr 2015 Apr; 169 (4): 323.
19. EXPRESS Group. One-year survival of extremely preterm infants after active perinatal care in Sweden. JAMA 2009; 301: 2225–2233.
20. Stoll BJ, Hansen NI, Bell EF, et al. Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network. Pediatrics 2010; 126: 443–456.
21. Canadian Neonatal Network. Prediction of neonatal outcomes in extremely preterm neonates. Pediatrics 2013; 132: 876–885.
22. Výsledky Neonatologické péče v ČR v jednotlivých hmotnostních kategoriích v roce 2015 a 2016. Česká neonatologická společnost ČLS JEP, dostupné online na: http://www.neonatology.cz/vysledky-pece-v-cr.
23. Rodička a novorozenec 2014–2015. Praha: ÚZIS, 2017.
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Neonatology Paediatrics General practitioner for children and adolescentsArticle was published in
Czech-Slovak Pediatrics
2018 Issue 1
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