Wide variation in severe neonatal morbidity among very preterm infants in European regions.
Wide variation in severe neonatal morbidity among very preterm infants in European regions.
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DOI：
10.1136/archdischild-2017-313697
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发表时间：
2019-01
期刊：
影响因子：
--
通讯作者：
Epice Research Group
中科院分区：
文献类型：
--
作者：
Edstedt Bonamy AK;Zeitlin J;Piedvache A;Maier RF;van Heijst A;Varendi H;Manktelow BN;Fenton A;Mazela J;Cuttini M;Norman M;Petrou S;Reempts PV;Barros H;Draper ES;Epice Research Group
调查欧洲各地区极早产儿（VPT）重症新生儿发病率的差异，以及死亡率低的地区的发病率是否高于死亡率高的地区。以地区为基础的队列研究，研究对象为所有孕周前出生的婴儿。2011/2012年在11个欧洲国家的16个地区。从新生儿护理中心出院的幸存者（n=6422）。重度新生儿发病定义为ⅲ级和ⅳ级脑室内出血、囊性脑室周围白质软化症、手术坏死性小肠结肠炎和早产儿视网膜病变≥3级。次要结局包括严重支气管肺发育不良（BPD），数据来自14个地区。在从医疗记录中提取数据之前，已经建立了新生儿发病率的共同定义。调整产妇和新生儿特征后，地区重症新生儿发病率与地区活产住院死亡率相关。10.6%的幸存者有严重的新生儿发病率，但没有严重的BPD（地区范围6.4%-23.5%），13.8%的幸存者有严重的BPD（地区范围10.0%-23.5%）。调整后的住院死亡率为13.7%（地区范围为8.4%-18.8%）。在考虑了孕产妇和新生儿的特征后，地区之间的差异仍然显著（P<0.001），重症新生儿发病率与死亡率无关（P=0.50）。VPT幸存者的严重新生儿发病率在欧洲各地区差异很大，与死亡率无关。
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. Area-based cohort study of all births before 32 weeks of gestational age. 16 regions in 11 European countries in 2011/2012. Survivors to discharge from neonatal care (n=6422). 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. 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). Severe neonatal morbidity rates for VPT survivors varied widely across European regions and were independent of mortality rates.
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DOI：
10.1111/j.1471-0528.2007.01611.x
发表时间：
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影响因子：
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DOI：
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发表时间：
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