1. Survival and causes of death in extremely preterm infants in the Netherlands
- Author
-
René F. Kornelisse, Arno van Heijst, Frank A B A Schuerman, Ruben S G M Witlox, Jacqueline L. van Hillegersberg, Koen P. Dijkman, Wes Onland, Peter H. Dijk, Frank A. M. van den Dungen, Floris Groenendaal, Peter Andriessen, Lisa Broeders, Elke van Westering-Kroon, Pauline E. van Beek, Pediatrics, Neonatology, ARD - Amsterdam Reproduction and Development, Kindergeneeskunde, MUMC+: MA Medische Staf Kindergeneeskunde (9), RS: GROW - R4 - Reproductive and Perinatal Medicine, Pediatric surgery, Amsterdam Reproduction & Development (AR&D), Eindhoven MedTech Innovation Center, Signal Processing Systems, and School of Med. Physics and Eng. Eindhoven
- Subjects
Male ,Pediatrics ,Time Factors ,Neonatal intensive care unit ,Newborn/mortality ,Infant, Premature, Diseases ,SDG 3 – Goede gezondheid en welzijn ,Cohort Studies ,Cause of Death ,Infant Mortality ,Infant, Very Low Birth Weight ,Respiratory Distress Syndrome, Newborn/mortality ,LOW-BIRTH-WEIGHT ,Hospital Mortality ,Neonatal/statistics & numerical data ,Netherlands ,Original Research ,Cause of death ,Hospital Mortality/trends ,Respiratory Distress Syndrome ,OUTCOMES ,BORN ,Stillbirth/epidemiology ,Obstetrics and Gynecology ,Gestational age ,Diseases/mortality ,General Medicine ,Stillbirth ,Intensive Care Units ,Necrotizing/mortality ,Infant, Extremely Premature ,Neonatal Sepsis/mortality ,Female ,Neonatal Sepsis ,medicine.symptom ,Cohort study ,medicine.medical_specialty ,Cause of Death/trends ,Gestational Age ,Netherlands/epidemiology ,IMPROVEMENT ,Extremely Premature ,neonatology ,WEEKS GESTATION ,Intensive Care Units, Neonatal/statistics & numerical data ,MORBIDITY ,SDG 3 - Good Health and Well-being ,Enterocolitis, Necrotizing ,Intensive Care Units, Neonatal ,medicine ,Humans ,Neonatology ,Enterocolitis, Necrotizing/mortality ,Premature ,Survival analysis ,Respiratory Distress Syndrome, Newborn ,Enterocolitis ,business.industry ,Very Low Birth Weight ,MORTALITY ,Infant, Newborn ,Infant ,Guideline ,CARE ,Newborn ,Survival Analysis ,TRENDS ,Infant, Premature, Diseases/mortality ,Low birth weight ,Pediatrics, Perinatology and Child Health ,business - Abstract
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%, pConclusionsImplementation 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.
- Published
- 2021
- Full Text
- View/download PDF