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1. The International Network for Evaluating Outcomes (iNeo) of neonates: evolution, progress and opportunities

Author

Shah, PS, Lui, K, Reichman, B, Norman, M, Kusuda, S, Lehtonen, L, Adams, M, Vento, M, Darlow, BA, Modi, N, Rusconi, F, Hakansson, S, San Feliciano, L, Helenius, KK, Bassler, D, Hirano, S, Lee, SK, Marshall, P, Schmidt, P, Dhawan, A, Craven, P, De Waal, K, Simmer, K, Gill, A, Pillow, J, Stack, J, Birch, P, Cooke, L, Casalaz, D, Holberton, J, Stewart, A, Downe, L, Stewart, M, Bajuk, B, Berry, A, Hunt, R, Kilburn, C, De Paoli, T, Bolisetty, S, Paradisis, M, Rieger, I, Koorts, P, Kuschel, C, Numa, A, Carlisle, H, Badawi, N, Loughran-Fowlds, A, Koh, G, Davis, J, Luig, M, Andersen, C, Chambers, G, Austin, N, Lynn, A, Darlow, B, Edmonds, L, Mildenhall, L, Buksh, M, Battin, M, Van den Boom, J, Bourchier, D, Richardson, V, Dineen, F, Rajadurai, VS, Fung, G, Harrison, A, Synnes, A, Ting, J, Cieslak, Z, Sherlock, R, Yee, W, Aziz, K, Toye, J, Fajardo, C, Kalapesi, Z, Sankaran, K, Daspal, S, Seshia, M, Alvaro, R, Mukerji, A, Da Silva, O, Nwaesei, C, Lee, K-S, Dunn, M, Lemyre, B, Dow, K, Pelausa, E, Barrington, K, Drolet, C, Piedboeuf, B, Claveau, M, Beltempo, M, Bertelle, V, Masse, E, Canning, R, Mabry, H, Ojah, C, Monterrosa, L, Deshpandey, A, Afifi, J, Kajetanowicz, A, Andersson, S, Tammela, O, Sankilampi, U, Saarela, T, Prazad, P, Noguchi, A, McWan, K, Button, B, Stratton, W, Hamvus, A, Raghaven, A, Derrick, M, Hadley, R, Covert, R, Lablanc, O, Weiss, M, Bell, A, Shareef, M, Silvestri, J, Heymann, E, Zangen, S, Smolkin, T, Mimouni, F, Bader, D, Rothschild, A, Strauss, Z, Felszer, C, Oman, H, Toy-Friedman, SE, Bar-Oz, B, Feldman, M, Saad, N, Flidel-Rimon, O, Weisbrod, M, Lubin, D, Litmanovitz, I, Kngelman, A, Shinwell, E, Klinger, G, Nijim, Y, Bin-Nun, A, Golan, A, Mandel, D, Fleisher-Sheffer, V, Kohelet, D, Bakhrakh, L, Hattori, S, Shirai, M, Ishioka, T, Mori, T, Amiznka, T, Huchimukai, T, Yoshida, H, Sasaki, A, Shimizu, J, Nakamura, T, Maruyama, M, Matsumoto, H, Hosokawa, S, Taki, A, Nakagawa, M, Ko, K, Uozumi, A, Nakata, S, Shimazaki, A, Yoda, T, Numata, O, Imamura, H, Kobayashi, A, Tokuriki, S, Uchida, Y, Arai, T, Ito, M, Ieda, K, Ono, T, Hayashi, M, Maki, K, Yamakawa, M, Kawai, M, Fujii, N, Shiomi, K, Nozaki, K, Wada, H, Kim, T, Tokunaga, Y, Takatera, A, Oshima, T, Sumida, H, Michinomae, Y, Knsumoto, Y, Yoshimoto, S, Morisawa, T, Ohashi, T, Takahashi, Y, Sugimoto, M, Ono, N, Miyagawa, S, Saijo, T, Yamagami, T, Koyano, K, Kobayashi, S, Kanda, T, Sakemi, Y, Aoki, M, Iida, K, Goshi, M, Maruyama, Y, Avila-Alvarez, A, Luis Fernandez-Trisac, J, Couce Pico, ML, Fernandez Seara, MJ, Martinez Gutierrez, A, Vizcaino, C, Salvador Iglesias, M, Sanchez Zaplana, H, Fernandez Colomer, B, Garcia Lopez, JE, Garcia Mozo, R, Gonzalez Martinez, MT, Muro Sebastian, MD, Balart Carbonell, M, Badia Bamnsell, J, Domingo Puiggros, M, Figueras Aloy, J, Botet Mussons, F, Anquela Sanz, I, Ginovart Galiana, G, Coroleu, W, Iriondo, M, Vilella, LC, Porta, R, Demestre, X, Martinez Nadal, S, De Frutos Martinez, C, Lopez Cuesta, MJ, Esquivel Mora, D, Ortiz Tardio, J, Benavente, I, Alonso, A, Aguilera Olmos, R, Garcia Cabezas, MA, Martinez Jimenez, MD, Jaraba Caballero, MF, Ordofiez Diaz, MD, Fagundo, AT, Canals, LM, Garcia-Munoz Rodrigo, F, Urquia Marti, L, Moreno Galdo, MF, Hurtado Suazo, JA, Narbona Lopez, E, Uberos Fernandez, J, Cortajarena Altana, MA, Mora Navarro, D, Teresa Dominguez, M, Ruiz del Prado, MY, Esteban Diez, I, Palau Benavides, MT, Lapena, S, Prada, T, Soler Mir, E, Corredera Sanchez, A, Criado Vega, E, Del Prado, N, Fernandez, C, Cabanillas Vilaplana, L, Cuadrado Perez, I, Lopez Gomez, L, Domingo Comeche, L, Llana Martin, I, Gonzalez Armengod, C, Munoz Labian, C, Santos Munoz, MJ, Blanco Bravo, D, Perez, V, Elorza Fernandez, MD, Diaz Gonzalez, C, Ares Segura, S, Lopez Azorin, M, Belen Jimenez, A, Sanchez-Tamayo, T, Tapia Moreno, E, Gonzalez, M, Sanchez Martinez, JE, Lloreda Garcia, JM, Goni Orayen, C, Vilas Gonzalez, J, Suarez Albo, M, Gonzalez Colmenero, E, Gutierrez Gonzalez, EP, Vacas del Arco, B, Marquez Fernandez, J, Acosta Gordillo, L, Granero Asensio, M, Macias Diaz, C, Albujar, M, Fuster Jorge, P, Romero, S, Rivero Falero, M, Escobar Izquierdo, AB, Estan Capell, J, Izquierdo Macian, MI, Montejo Vicente, MM, Izquierdo Caballero, R, Mercedes Martinez, M, Euba, A, Rodriguez Serna, A, De Heredia Goya, JML, Perez Legorburu, A, Gutierrez Amoros, A, Marugan Isabel, VM, Hernandez Gonzalez, N, Rite Gracia, S, Ventura Faci, MP, Samper Villagrasa, MP, Kofron, J, Brodd, KS, Odlind, A, Alberg, L, Arwehed, S, Hafstrom, O, Kasemo, A, Nederman, K, Ahman, L, Ingemarsson, F, Petersson, H, Thum, P, Albinsson, E, Selander, B, Abrahamsson, T, Heimdahl, I, Sveinsdottir, K, Wejryd, E, Hedlund, A, Soderberg, MK, Hallberg, B, Brune, T, Backstrom, J, Robinson, J, Farooqi, A, Normann, E, Fredriksson, M, Palm, A, Rosenqvist, U, Hagman, C, Ohlin, A, Floral, R, Smedsaas-Lofvenberg, A, Meyer, P, Anderegg, C, Schulzke, S, Nelle, M, Wagner, B, Riedel, T, Kaczala, G, Walde, B, Pfister, RE, Tolsa, J-F, Roth, M, Stocker, M, Laubscher, B, Malzacher, A, Micallef, JP, Hegi, L, Arlettaz, R, Bernet, V, Dani, C, Fiorini, P, Boldrini, A, Tomasini, B, Mittal, A, Kefas, J, Kamalanathan, A, Jayachandran, Yoxall, B, McBride, T, Webb, D, Garr, R, Hassan, A, Ambadkar, P, Dyke, M, McDevitt, K, Rewitzky, G, D'Amore, A, Panasa, N, Settle, P, Maddock, N, Edi-Osagie, N, Zipitis, C, Heal, C, Birch, J, Hasib, A, Soe, A, Kumar, N, Kisat, H, Vasu, V, Lama, M, Gupta, R, Rawlingson, C, Wickham, T, Theron, M, Kendall, G, Gupta, A, Aladangady, N, Ali, I, Alsford, L, Lopez, W, Murthy, V, Sullivan, C, Thomas, M, Bate, T, Godambe, S, Watts, T, Kuna, J, Chang, J, Pai, V, Huddy, C, Yasin, S, Nicholl, R, Pandey, P, Kairamkonda, V, Muogbo, D, Harry, L, Simmons, P, Nycyk, J, Gallagher, A, Pillay, T, Deshpande, S, Mahadevan, Moore, A, Clark, S, Garbash, M, Lal, M, Abu-Harb, M, Allwood, A, Selter, M, Munyard, P, Bartle, D, Paul, S, Whincup, G, Mallik, A, Amess, P, Godden, C, Reynolds, P, Misra, I, De Halpert, P, Salgia, S, Sanghavi, R, Wigfield, R, Deketelaere, A, Khashu, M, Hall, M, Groves, C, Brown, N, Brennan, N, Vamvakiti, K, McIntyre, J, Pirie, S, Jones, S, Mannix, P, Cairns, P, Eaton, M, Schwarz, K, Gibson, D, Miall, L, Krishnamurthy, University of Zurich, Shah, Prakesh S, Canadian Institutes of Health Research (CIHR), and Neonid NPO

Subjects
medicine.medical_specialty, NEW-ZEALAND, Population, 610 Medicine & health, RETINOPATHY, Review Article, Audit, Pediatrics, outcomes research, MORBIDITY, Nursing, neonatal intensive care, Health care, medicine, LOW-BIRTH-WEIGHT, 2735 Pediatrics, Perinatology and Child Health, education, education.field_of_study, Science & Technology, EXTREMELY PRETERM INFANTS, business.industry, MORTALITY, Public health, Health services research, Preterm infants, Capacity building, BRONCHOPULMONARY DYSPLASIA, Benchmarking, 10027 Clinic for Neonatology, INTENSIVE-CARE UNITS, TRENDS, CANADA, Pediatrics, Perinatology and Child Health, Outcomes research, business, Life Sciences & Biomedicine
Abstract

Neonates born very preterm (before 32 weeks’ gestational age), are a significant public health concern because of their high-risk of mortality and life-long disability. In addition, caring for very preterm neonates can be expensive, both during their initial hospitalization and their long-term cost of permanent impairments. To address these issues, national and regional neonatal networks around the world collect and analyse data from their constituents to identify trends in outcomes, and conduct benchmarking, audit and research. Improving neonatal outcomes and reducing health care costs is a global problem that can be addressed using collaborative approaches to assess practice variation between countries, conduct research and implement evidence-based practices. The International Network for Evaluating Outcomes (iNeo) of neonates was established in 2013 with the goal of improving outcomes for very preterm neonates through international collaboration and comparisons. To date, 10 national or regional population-based neonatal networks/datasets participate in iNeo collaboration. The initiative now includes data on >200,000 very preterm neonates and has conducted important epidemiological studies evaluating outcomes, variations and trends. The collaboration has also surveyed >320 neonatal units worldwide to learn about variations in practices, healthcare service delivery, and physical, environmental and manpower related factors and support services for parents. The iNeo collaboration serves as a strong international platform for Neonatal-Perinatal health services research that facilitates international data sharing, capacity building, and global efforts to improve very preterm neonate care.

Published
2019

2. The International Network for Evaluating Outcomes (iNeo) of neonates: evolution, progress and opportunities

Author

Shah P, Lui K, Reichman B, Norman M, Kusuda S, Lehtonen L, Adams M, Vento M, Darlow B, Modi N, Rusconi F, Hakansson S, San Feliciano L, Helenius K, Bassler D, Hirano S, Lee S, Marshall P, Schmidt P, Dhawan A, Craven P, de Waal K, Simmer K, Gill A, Pillow J, Stack J, Birch P, Cooke L, Casalaz D, Holberton J, Stewart A, Downe L, Stewart M, Bajuk B, Berry A, Hunt R, Kilburn C, De Paoli T, Bolisetty S, Paradisis M, Rieger I, Koorts P, Kuschel C, Numa A, Carlisle H, Badawi N, Loughran-Fowlds A, Koh G, Davis J, Luig M, Andersen C, Chambers G, Austin N, Lynn A, Edmonds L, Mildenhall L, Buksh M, Battin M, van den Boom J, Bourchier D, Richardson V, Dineen F, Rajadurai V, Fung G, Harrison A, Synnes A, Ting J, Cieslak Z, Sherlock R, Yee W, Aziz K, Toye J, Fajardo C, Kalapesi Z, Sankaran K, Daspal S, Seshia M, Alvaro R, Mukerji A, Da Silva O, Nwaesei C, Lee K, Dunn M, Lemyre B, Dow K, Pelausa E, Barrington K, Drolet C, Piedboeuf B, Claveau M, Beltempo M, Bertelle V, Masse E, Canning R, Mabry H, Ojah C, Monterrosa L, Deshpandey A, Afifi J, Kajetanowicz A, Andersson S, Tammela O, Sankilampi U, Saarela T, Prazad P, Noguchi A, McWan K, Button B, Stratton W, Hamvus A, Raghaven A, Derrick M, Hadley R, Covert R, Lablanc O, Weiss M, Bell A, Shareef M, Silvestri J, Heymann E, Zangen S, Smolkin T, Mimouni F, Bader D, Rothschild A, Strauss Z, Felszer C, Oman H, Toy-Friedman S, Bar-Oz B, Feldman M, Saad N, Flidel-Rimon O, Weisbrod M, Lubin D, Litmanovitz I, Kngelman A, Shinwell E, Klinger G, Nijim Y, Bin-Nun A, Golan A, Mandel D, Fleisher-Sheffer V, Kohelet D, Bakhrakh L, Hattori S, Shirai M, Ishioka T, Mori T, Amiznka T, Huchimukai T, Yoshida H, Sasaki A, Shimizu J, Nakamura T, Maruyama M, Matsumoto H, Hosokawa S, Taki A, Nakagawa M, Ko K, Uozumi A, Nakata S, Shimazaki A, Yoda T, Numata O, Imamura H, Kobayashi A, Tokuriki S, Uchida Y, Arai T, Ito M, Ieda K, Ono T, Hayashi M, Maki K, Yamakawa M, Kawai M, Fujii N, Shiomi K, Nozaki K, Wada H, Kim T, Tokunaga Y, Takatera A, Oshima T, Sumida H, Michinomae Y, Knsumoto Y, Yoshimoto S, Morisawa T, Ohashi T, Takahashi Y, Sugimoto M, Ono N, Miyagawa S, Saijo T, Yamagami T, Koyano K, Kobayashi S, Kanda T, Sakemi Y, Aoki M, Iida K, Goshi M, Maruyama Y, Avila-Alvarez A, Fernandez-Trisac J, Pico M, Seara M, Gutierrez A, Vizcaino C, Iglesias M, Zaplana H, Colomer B, Lopez J, Mozo R, Martinez M, Sebastian M, Carbonell M, Bamnsell J, Puiggros M, Aloy J, Mussons F, Sanz I, Galiana G, Coroleu W, Iriondo M, Vilella L, Porta R, Demestre X, Nadal S, Martinez C, Cuesta M, Mora D, Tardio J, Benavente I, Alonso A, Olmos R, Cabezas M, Jimenez M, Caballero M, Diaz M, Fagundo A, Canals L, Rodrigo F, Marti L, Galdo M, Suazo J, Lopez E, Fernandez J, Altana M, Navarro D, Dominguez M, del Prado M, Diez I, Benavides M, Lapena S, Prada T, Mir E, Sanchez A, Vega E, del Prado N, Fernandez C, Vilaplana L, Perez I, Gomez L, Comeche L, Martin I, Armengod C, Labian C, Munoz M, Bravo D, Perez V, Fernandez M, Gonzalez C, Segura S, Azorin M, Jimenez A, Sanchez-Tamayo T, Moreno E, Gonzalez M, Martinez J, Garcia J, Orayen C, Gonzalez J, Albo M, Colmenero E, Gonzalez E, del Arco B, Gordillo L, Asensio M, Diaz C, Albujar M, Jorge P, Romero S, Falero M, Izquierdo A, Capell J, Macian M, Vicente M, Caballero R, Euba A, Serna A, Goya J, Legorburu A, Amoros A, Isabel V, Gonzalez N, Gracia S, Faci M, Villagrasa M, Kofron J, Brodd K, Odlind A, Alberg L, Arwehed S, Hafstrom O, Kasemo A, Nederman K, Ahman L, Ingemarsson F, Petersson H, Thum P, Albinsson E, Selander B, Abrahamsson T, Heimdahl I, Sveinsdottir K, Wejryd E, Hedlund A, Soderberg M, Hallberg B, Brune T, Backstrom J, Robinson J, Farooqi A, Normann E, Fredriksson M, Palm A, Rosenqvist U, Hagman C, Ohlin A, Floral R, Smedsaas-Lofvenberg A, Meyer P, Anderegg C, Schulzke S, Nelle M, Wagner B, Riedel T, Kaczala G, Walde B, Pfister R, Tolsa J, Roth M, Stocker M, Laubscher B, Malzacher A, Micallef J, Hegi L, Arlettaz R, Bernet V, Dani C, Fiorini P, Boldrini A, Tomasini B, Mittal A, Kefas J, Kamalanathan A, Jayachandran, Yoxall B, McBride T, Webb D, Garr R, Hassan A, Ambadkar P, Dyke M, McDevitt K, Rewitzky G, D'Amore A, Panasa N, Settle P, Maddock N, Edi-Osagie N, Zipitis C, Heal C, Birch J, Hasib A, Soe A, Kumar N, Kisat H, Vasu V, Lama M, Gupta R, Rawlingson C, Wickham T, Theron M, Kendall G, Gupta A, Aladangady N, Ali I, Alsford L, Lopez W, Murthy V, Sullivan C, Thomas M, Bate T, Godambe S, Watts T, Kuna J, Chang J, Pai V, Huddy C, Yasin S, Nicholl R, Pandey P, Kairamkonda V, Muogbo D, Harry L, Simmons P, Nycyk J, Gallagher A, Pillay T, Deshpande S, Mahadevan, Moore A, Clark S, Garbash M, Lal M, Abu-Harb M, Allwood A, Selter M, Munyard P, Bartle D, Paul S, Whincup G, Mallik A, Amess P, Godden C, Reynolds P, Misra I, De Halpert P, Salgia S, Sanghavi R, Wigfield R, Deketelaere A, Khashu M, Hall M, Groves C, Brown N, Brennan N, Vamvakiti K, McIntyre J, Pirie S, Jones S, Mannix P, Cairns P, Eaton M, Schwarz K, Gibson D, Miall L, Krishnamurthy, and Int Network Evaluating Outcomes iN

Subjects
outcomes research, neonatal intensive care, Preterm infants
Abstract

Neonates born very preterm (before 32 weeks' gestational age), are a significant public health concern because of their high-risk of mortality and life-long disability. In addition, caring for very preterm neonates can be expensive, both during their initial hospitalization and their long-term cost of permanent impairments. To address these issues, national and regional neonatal networks around the world collect and analyse data from their constituents to identify trends in outcomes, and conduct benchmarking, audit and research. Improving neonatal outcomes and reducing health care costs is a global problem that can be addressed using collaborative approaches to assess practice variation between countries, conduct research and implement evidence-based practices. The International Network for Evaluating Outcomes (iNeo) of neonates was established in 2013 with the goal of improving outcomes for very preterm neonates through international collaboration and comparisons. To date, 10 national or regional population-based neonatal networks/datasets participate in iNeo collaboration. The initiative now includes data on >200,000 very preterm neonates and has conducted important epidemiological studies evaluating outcomes, variations and trends. The collaboration has also surveyed >320 neonatal units worldwide to learn about variations in practices, healthcare service delivery, and physical, environmental and manpower related factors and support services for parents. The iNeo collaboration serves as a strong international platform for Neonatal-Perinatal health services research that facilitates international data sharing, capacity building, and global efforts to improve very preterm neonate care.

Published
2019

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

Author

Lui K, Lee S, Kusuda S, Adams M, Vento M, Reichman B, Darlow B, Lehtonen L, Modi N, Norman M, Hakansson S, Bassler D, Rusconi F, Lodha A, Yang J, Shah P, Marshall P, Schmidt P, Dhawan A, Craven P, de Waal K, Simmer K, Gill A, Pillow J, Stack J, Birch P, Cooke L, Casalaz D, Holberton J, Stewart A, Downe L, Stewart M, Bajuk B, Berry A, Hunt R, Kilburn C, De Paoli T, Bolisetty S, Paradisis M, Rieger I, Koorts P, Kuschel C, Doyle L, Numa A, Carlisle H, Badawi N, Loughran-Fowlds A, Koh G, Davis J, Luig M, Andersen C, Chambers G, Austin N, Lynn A, Edmonds L, Mildenhall L, Buksh M, Battin M, van den Boom J, Bourchier D, Richardson V, Dineen F, Rajadurai V, Lam S, Fung G, Harrison A, Synnes A, Cieslak Z, Sherlock R, Yee W, Aziz K, Fajardo C, Kalapesi Z, Sankaran K, Daspal S, Seshia M, Alvaro R, Mukerji A, Da Silva O, Nwaesei C, Lee K, Dunn M, Lemyre B, Dow K, Pelausa E, Barrington K, Drolet C, Piedboeuf B, Claveau M, Beltempo M, Bertelle V, Masse E, Canning R, Makary H, Ojah C, Monterrosa L, Deshpandey A, Afifi J, Kajetanowicz A, Andersson S, Tammela O, Sankilampi U, Saarela T, Prazad P, Noguchi A, McWan K, Button B, Stratton W, Hamvus A, Raghaven A, Derrick M, Hadley R, Covert R, Lablanc O, Weiss M, Bell A, Shareef M, Silvestri J, Heymann E, Zangen S, Smolkin T, Mimouni F, Bader D, Rothschild A, Strauss Z, Felszer C, Omari H, Tov-Friedman S, Bar-Oz B, Feldman M, Saad N, Flidel-Rimon O, Weisbrod M, Lubin D, Litmanovitz I, Kugelman A, Shinwell E, Klinger G, Nijim Y, Bin-Nun A, Golan A, Mandel D, Fleisher-Sheffer V, Kohelet D, Bakhrakh L, Hattori S, Shirai M, Ishioka T, Mori T, Amizuka T, Huchimukai T, Yoshida H, Sasaki A, Shimizu J, Nakamura T, Maruyama M, Matsumoto H, Hosokawa S, Taki A, Nakagawa M, Ko K, Uozumi A, Nakata S, Shimazaki A, Yoda T, Numata O, Imamura H, Kobayashi A, Tokuriki S, Uchida Y, Arai T, Ito M, Ieda K, Ono T, Hayashi M, Maki K, Yamakawa M, Kawai M, Fujii N, Shiomi K, Nozaki K, Wada H, Kim T, Tokunaga Y, Takatera A, Oshima T, Sumida H, Michinomae Y, Kusumoto Y, Yoshimoto S, Morisawa T, Ohashi T, Takahashi Y, Sugimoto M, Ono N, Miyagawa S, Saijo T, Yamagami T, Koyano K, Kobayashi S, Kanda T, Sakemi Y, Aoki M, Iida K, Goshi M, Maruyama Y, Avila-Alvarez A, Ting J, Toye J, Fernandez-Trisac J, Pico M, Seara M, Gutierrez A, Vizcaino C, Iglesias M, Zaplana H, Colomer B, Lopez J, Mozo R, Martinez M, Sebastian M, Carbonell M, Barnusell J, Puiggros M, Aloy J, Mussons F, Sanz I, Galiana G, Coroleu W, Iriondo M, Vilella L, Porta R, Demestre X, Nadal S, Martinez C, Cuesta M, Mora D, Tardio J, Benavente I, Alonso A, Olmos R, Cabezas M, Jimenez M, Caballero P, Diaz M, Fagundo A, Canals L, Rodrigo F, Marti L, Galdo M, Suazo J, Lopez E, Fernandez J, Altuna M, Muga O, Navarro D, Dominguez M, del Prado M, Diez I, Benavides M, Lapena S, Prada T, Mir E, Sanchez A, Vega E, del Prado N, Fernandez C, Vilaplana L, Perez I, Gomez L, Comeche L, Martin I, Armengod C, Labian C, Munoz M, Bravo D, Perez V, Fernandez M, Gonzalez C, Segura S, Azorin M, Jimenez A, Sanchez-Tamayo T, Moreno E, Gonzalez M, Martinez J, Garcia J, Orayen C, Gonzalez J, Albo M, Colmenero E, Gonzalez E, del Arco B, Gordillo L, Asensio M, Diaz C, Albujar R, Jorge P, Romero S, Falero M, Izquierdo A, Capell J, Vicente M, Caballero R, Euba A, Serna A, Goya J, Legorburu A, Amoros A, Isabel V, Gonzalez N, Gracia S, Faci P, Villagrasa M, Macian M, Kofron J, Brodd K, Odlind A, Alberg L, Arwehed S, Hafstrom O, Kasemo A, Nederman K, Ahman L, Ingemarsson F, Petersson H, Thurn P, Albinsson E, Selander B, Abrahamsson T, Heimdahl I, Sveinsdottir K, Wejryd E, Hedlund A, Soderberg M, Hallberg B, Brune T, Backstrom J, Robinson J, Farooqi A, Normann E, Fredriksson M, Palm A, Rosenqvist U, Walde B, Hagman C, Ohlin A, Florell R, Smedsaas-Lofvenberg A, Meyer P, Anderegg C, Schulzke S, Nelle M, Wagner B, Riedel T, Kaczala G, Pfister R, Tolsa J, Roth M, Stocker M, Laubscher B, Malzacher A, Micallef J, Hegi L, Arlettaz R, Bernet V, Fiorini P, Boldrini A, Tomasini B, Kefas J, Kamalanathan A, Jayachandran, Yoxall B, McBride T, Webb D, Garr R, Hassan A, Ambadkar P, Dyke M, McDevitt K, Rewitzky G, D'Amore A, Panasa N, Settle P, Maddock N, Edi-Osagie N, Zipitis C, Heal C, Birch J, Hasib A, Soe A, Kumar N, Kisat H, Vasu V, Lama M, Gupta R, Rawlingson C, Wickham T, Theron M, Kendall G, Gupta A, Aladangady N, Ali I, Alsford L, Lopez W, Murthy V, Sullivan C, Thomas M, Bate T, Godambe S, Watts T, Kuna J, Chang J, Pai V, Huddy C, Yasin S, Nicholl R, Pandey P, Cusack J, Kairamkonda V, Muogbo D, Harry L, Simmons P, Nycyk J, Gallagher A, Pillay T, Deshpande S, Mahadevan, Moore A, Clark S, Garbash M, Lal M, Abu-Harb M, Dani C, Mittal A, Allwood A, Selter M, Munyard P, Bartle D, Paul S, Whincup G, Mallik A, Amess P, Godden C, Reynolds P, Misra I, De Halpert P, Salgia S, Sanghavi R, Wigfield R, Deketelaere A, Khashu M, Hall M, Groves C, Brown N, Brennan N, Vamvakiti K, McIntyre J, Pirie S, Jones S, Mannix P, Cairns P, Eaton M, Schwarz K, Gibson D, Miall L, Krishnamurthy, and Int Network Evaluation Outcomes iN

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

Published
2019

4. Comparing very low birth weight versus very low gestation cohort methods for outcome analysis of high risk preterm infants.

Author

Austin N., Andersen C., Darlow B., Broadbent R., Corban J., Mildenhall L., Battin M., Bourchier D., Richardson V., Haslam R., Rajadurai V.S., Kajetanowicz A., Synnes A., Rouvinez-Bouali N., Piedboeuf B., Bertelle V., Bulleid B., Yee W., Shivananda S., Lee K.-S., Seshia M., Barrington K., Lefebvre F., McMillan D., Andrews W., Kovacs L., Dow K., da Silva O., Riley P., Peliowski A., Aziz K., Cieslak Z., Kalapesi Z., Sankaran K., Faucher D., Alvaro R., Canning R., Ojah C., Monterrosa L., Dunn M., Sorokan T., Harrison A., Nwaesei C., Adie M., Hakansson S., Segerdahl N., Morad T., Moren S., Stenberg A., Simonsson C., Stigsson L., Christensen J.L., Amasn L., Ingemanson F., osterdal L., Ellstrom K.-G., Abrahamsson T., Heimdahl I., Hagg T., Hedlund A., Lund E.E., Westrup B., Sarman I., Jobe A.S., Fredsriksson M., Palm A., Malmstrom B., Lindberg E., Ljungdahl O., Eriksson K., Koller-Smith L.I.M., Shah P., Ye X.Y., Sjors G., Wang Y.A., Chow S.S.W., Darlow B.A., Lee S.K., Hakanson S., Lui K., Marshall P., Craven P., Simmer K., Stack J., Knight D., Watkins A., Ramsden A., Tan K., Bawden K., Downe L., Singde V., Stewart M., Berry A., Hunt R., Kilburn C., Dargaville P., Paradisis M., Evans N., Reid S., Cartwright D., Kuschel C., Doyle L., Numa A., Kecskes Z., Badawi N., Koh G., Resnick S., Tracy M., Tarnow-Mordi W., Austin N., Andersen C., Darlow B., Broadbent R., Corban J., Mildenhall L., Battin M., Bourchier D., Richardson V., Haslam R., Rajadurai V.S., Kajetanowicz A., Synnes A., Rouvinez-Bouali N., Piedboeuf B., Bertelle V., Bulleid B., Yee W., Shivananda S., Lee K.-S., Seshia M., Barrington K., Lefebvre F., McMillan D., Andrews W., Kovacs L., Dow K., da Silva O., Riley P., Peliowski A., Aziz K., Cieslak Z., Kalapesi Z., Sankaran K., Faucher D., Alvaro R., Canning R., Ojah C., Monterrosa L., Dunn M., Sorokan T., Harrison A., Nwaesei C., Adie M., Hakansson S., Segerdahl N., Morad T., Moren S., Stenberg A., Simonsson C., Stigsson L., Christensen J.L., Amasn L., Ingemanson F., osterdal L., Ellstrom K.-G., Abrahamsson T., Heimdahl I., Hagg T., Hedlund A., Lund E.E., Westrup B., Sarman I., Jobe A.S., Fredsriksson M., Palm A., Malmstrom B., Lindberg E., Ljungdahl O., Eriksson K., Koller-Smith L.I.M., Shah P., Ye X.Y., Sjors G., Wang Y.A., Chow S.S.W., Darlow B.A., Lee S.K., Hakanson S., Lui K., Marshall P., Craven P., Simmer K., Stack J., Knight D., Watkins A., Ramsden A., Tan K., Bawden K., Downe L., Singde V., Stewart M., Berry A., Hunt R., Kilburn C., Dargaville P., Paradisis M., Evans N., Reid S., Cartwright D., Kuschel C., Doyle L., Numa A., Kecskes Z., Badawi N., Koh G., Resnick S., Tracy M., and Tarnow-Mordi W.

Abstract

Background: Compared to very low gestational age (<32 weeks, VLGA) cohorts, very low birth weight (<1500 g; VLBW) cohorts are more prone to selection bias toward small-for-gestational age (SGA) infants, which may impact upon the validity of data for benchmarking purposes. Method(s): Data from all VLGA or VLBW infants admitted in the 3 Networks between 2008 and 2011 were used. Two-thirds of each network cohort was randomly selected to develop prediction models for mortality and composite adverse outcome (CAO: mortality or cerebral injuries, chronic lung disease, severe retinopathy or necrotizing enterocolitis) and the remaining for internal validation. Areas under the ROC curves (AUC) of the models were compared. Result(s): VLBW cohort (24,335 infants) had twice more SGA infants (20.4% vs. 9.3%) than the VLGA cohort (29,180 infants) and had a higher rate of CAO (36.5% vs. 32.6%). The two models had equal prediction power for mortality and CAO (AUC 0.83), and similarly for all other cross-cohort validations (AUC 0.81-0.85). Neither model performed well for the extremes of birth weight for gestation (<1500 g and >=32 weeks, AUC 0.50-0.65; >=1500 g and <32 weeks, AUC 0.60-0.62). Conclusion(s): There was no difference in prediction power for adverse outcome between cohorting VLGA or VLBW despite substantial bias in SGA population. Either cohorting practises are suitable for international benchmarking.Copyright © 2017 The Author(s).

Published
2017

5. Comparing very low birth weight versus very low gestation cohort methods for outcome analysis of high risk preterm infants

Author

Koller-Smith, LIM, Shah, PS, Ye, XY, Sjörs, G, Wang, YA, Chow, SSW, Darlow, BA, Lee, SK, Håkanson, S, Lui, K, Marshall, P, Craven, P, Simmer, K, Stack, J, Knight, D, Watkins, A, Ramsden, A, Tan, K, Bawden, K, Downe, L, Singde, V, Stewart, M, Berry, A, Hunt, R, Kilburn, C, Dargaville, P, Paradisis, M, Evans, N, Reid, S, Cartwright, D, Kuschel, C, Doyle, L, Numa, A, Kecskes, Z, Badawi, N, Koh, G, Resnick, S, Tracy, M, Tarnow-Mordi, W, Andersen, C, Austin, N, Darlow, B, Broadbent, R, Corban, J, Mildenhall, L, Battin, M, Bourchier, D, Richardson, V, Haslam, R, Rajadurai, VS, Kajetanowicz, A, Synnes, A, Rouvinez-Bouali, N, Piedboeuf, B, Bertelle, V, Bulleid, B, Yee, W, Shivananda, S, Lee, KS, Seshia, M, Barrington, K, Lefebvre, F, McMillan, D, Andrews, W, Kovacs, L, Dow, K, da Silva, O, Riley, P, Peliowski, A, Aziz, K, Cieslak, Z, Kalapesi, Z, Sankaran, K, Faucher, D, Alvaro, R, Canning, R, Ojah, C, Monterrosa, L, Dunn, M, Sorokan, T, Harrison, A, Nwaesei, C, Adie, M, Håkansson, S, Segerdahl, N, Morad, T, Morén, S, Stenberg, Å, Simonsson, C, Stigsson, L, Christensen, JL, Åmasn, L, Ingemanson, F, österdal, L, Ellström, KG, Abrahamsson, T, Heimdahl, I, Hägg, T, Hedlund, A, Lund, EE, Koller-Smith, LIM, Shah, PS, Ye, XY, Sjörs, G, Wang, YA, Chow, SSW, Darlow, BA, Lee, SK, Håkanson, S, Lui, K, Marshall, P, Craven, P, Simmer, K, Stack, J, Knight, D, Watkins, A, Ramsden, A, Tan, K, Bawden, K, Downe, L, Singde, V, Stewart, M, Berry, A, Hunt, R, Kilburn, C, Dargaville, P, Paradisis, M, Evans, N, Reid, S, Cartwright, D, Kuschel, C, Doyle, L, Numa, A, Kecskes, Z, Badawi, N, Koh, G, Resnick, S, Tracy, M, Tarnow-Mordi, W, Andersen, C, Austin, N, Darlow, B, Broadbent, R, Corban, J, Mildenhall, L, Battin, M, Bourchier, D, Richardson, V, Haslam, R, Rajadurai, VS, Kajetanowicz, A, Synnes, A, Rouvinez-Bouali, N, Piedboeuf, B, Bertelle, V, Bulleid, B, Yee, W, Shivananda, S, Lee, KS, Seshia, M, Barrington, K, Lefebvre, F, McMillan, D, Andrews, W, Kovacs, L, Dow, K, da Silva, O, Riley, P, Peliowski, A, Aziz, K, Cieslak, Z, Kalapesi, Z, Sankaran, K, Faucher, D, Alvaro, R, Canning, R, Ojah, C, Monterrosa, L, Dunn, M, Sorokan, T, Harrison, A, Nwaesei, C, Adie, M, Håkansson, S, Segerdahl, N, Morad, T, Morén, S, Stenberg, Å, Simonsson, C, Stigsson, L, Christensen, JL, Åmasn, L, Ingemanson, F, österdal, L, Ellström, KG, Abrahamsson, T, Heimdahl, I, Hägg, T, Hedlund, A, and Lund, EE

Abstract

© 2017 The Author(s). Background: Compared to very low gestational age (<32 weeks, VLGA) cohorts, very low birth weight (<1500 g; VLBW) cohorts are more prone to selection bias toward small-for-gestational age (SGA) infants, which may impact upon the validity of data for benchmarking purposes. Method: Data from all VLGA or VLBW infants admitted in the 3 Networks between 2008 and 2011 were used. Two-thirds of each network cohort was randomly selected to develop prediction models for mortality and composite adverse outcome (CAO: mortality or cerebral injuries, chronic lung disease, severe retinopathy or necrotizing enterocolitis) and the remaining for internal validation. Areas under the ROC curves (AUC) of the models were compared. Results: VLBW cohort (24,335 infants) had twice more SGA infants (20.4% vs. 9.3%) than the VLGA cohort (29,180 infants) and had a higher rate of CAO (36.5% vs. 32.6%). The two models had equal prediction power for mortality and CAO (AUC 0.83), and similarly for all other cross-cohort validations (AUC 0.81-0.85). Neither model performed well for the extremes of birth weight for gestation (<1500 g and ≥32 weeks, AUC 0.50-0.65; ≥1500 g and <32 weeks, AUC 0.60-0.62). Conclusion: There was no difference in prediction power for adverse outcome between cohorting VLGA or VLBW despite substantial bias in SGA population. Either cohorting practises are suitable for international benchmarking.

Published
2017

7. Contributors

Author

Abiodun, P.O., primary, Alam, Nurul, additional, Arora, N.K., additional, Axton, J., additional, Aziz, K.M.S., additional, Barnes, Graeme, additional, Bhan, M.K., additional, Bhui, P.S., additional, Biddulph, John, additional, Birch, Chris, additional, Bishop, Ruth, additional, Bundy, D.A.P., additional, Candy, D.C.A., additional, Chandra, R.K., additional, Chong, S.K.F., additional, Chopra, K., additional, Cooper, E.S., additional, Cullinan, T., additional, Cutting, William A.M., additional, Dhar, Ananta P., additional, Doiphode, S.H., additional, Dua, N., additional, Dunn, D.T., additional, Durie, P.R., additional, Elliott, Elizabeth, additional, Farthing, M.J.G., additional, Forstner, G.G., additional, Ganguly, Rita, additional, Ghai, O.P., additional, Gracey, Michael, additional, Hamilton, J.R., additional, Harland, Philip S.E.G., additional, Hunt, G., additional, Ihongbe, J.C., additional, Isaacs, D., additional, Jain, M.K., additional, Kaur, Paramjit, additional, Khan, Shakil, additional, Khoshoo, V., additional, Kronmal, R.A., additional, Lamabadusuriya, Sanath P., additional, Larcher, V., additional, Low, P.S., additional, Macfarlane, P.I., additional, Manuel, P.D., additional, Mata, L.J., additional, Mathan, V.I., additional, McLaren, Donald S., additional, McNeish, A.S., additional, Mehta, Ajita P., additional, Mehta, N.J., additional, Milla, Peter, additional, Miller, V., additional, Mittal, S.K., additional, Molla, Ayesha, additional, Molla, A.M., additional, Moore, D.J., additional, Mowat, Alex P., additional, Oboh, L., additional, Ojah, C., additional, Ooi, B.C., additional, Pangkatana, P., additional, Phillips, A.D., additional, Price, E., additional, Quak, S.H., additional, Raafat, F., additional, Rahaman, M. Mujibur, additional, Rahman, Mizanur, additional, Rao, N.S.N., additional, Reddy, D.C.S., additional, Rowland, M.G.M., additional, Rowland, S.G.J. Goh, additional, Saha, K., additional, Sane, S.Y., additional, Seth, Vimlesh, additional, Smith, Megan, additional, Tanner, M.S., additional, Taskar, S.P., additional, Tomkins, Andrew, additional, Tzipori, Saul, additional, Urrutia, J.J., additional, Walker-Smith, J.A., additional, Wong, H.B., additional, and Wright, Nicholas A., additional

Published
1986
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10. Pulmonary interstitial emphysema: selective bronchial occlusion with a Swan-Ganz catheter.

Author

LEWIS, S., PELAUSA, E., OJAH, C., and PAES, B.

Abstract

A 26 week preterm infant ventilated for hyaline membrane disease developed severe pulmonary interstitial emphysema with extensive right sided bullous formation, mediastinal shift, and subsequent left sided atelectasis. A paediatric Swan-Ganz catheter was used for selective bronchial occlusion with dramatic improvement in the infant's clinical condition and radiographic findings. [ABSTRACT FROM AUTHOR]

Published
1988
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11. Comparing very low birth weight versus very low gestation cohort methods for outcome analysis of high risk preterm infants

Author

Louise Koller-Smith, Shah, Ps, Ye, Xy, Sjörs, G., Wang, Ya, Chow, Ssw, Darlow, Ba, Lee, Sk, Håkanson, S., Lui, K., Marshall, P., Craven, P., Simmer, K., Stack, J., Knight, D., Watkins, A., Ramsden, A., Tan, K., Bawden, K., Downe, L., Singde, V., Stewart, M., Berry, A., Hunt, R., Kilburn, C., Dargaville, P., Paradisis, M., Evans, N., Reid, S., Cartwright, D., Kuschel, C., Doyle, L., Numa, A., Kecskes, Z., Badawi, N., Koh, G., Resnick, S., Tracy, M., Tarnow-Mordi, W., Andersen, C., Austin, N., Darlow, B., Broadbent, R., Corban, J., Mildenhall, L., Battin, M., Bourchier, D., Richardson, V., Haslam, R., Rajadurai, Vs, Kajetanowicz, A., Synnes, A., Rouvinez-Bouali, N., Piedboeuf, B., Bertelle, V., Bulleid, B., Yee, W., Shivananda, S., Lee, Ks, Seshia, M., Barrington, K., Lefebvre, F., Mcmillan, D., Andrews, W., Kovacs, L., Dow, K., Da Silva, O., Riley, P., Peliowski, A., Aziz, K., Cieslak, Z., Kalapesi, Z., Sankaran, K., Faucher, D., Alvaro, R., Canning, R., Ojah, C., Monterrosa, L., Dunn, M., Sorokan, T., Harrison, A., Nwaesei, C., Adie, M., Håkansson, S., Segerdahl, N., Morad, T., Morén, S., Stenberg, Å, Simonsson, C., Stigsson, L., Christensen, Jl, Åmasn, L., Ingemanson, F., Österdal, L., Ellström, Kg, Abrahamsson, T., Heimdahl, I., Hägg, T., Hedlund, A., and Lund, Ee

Subjects
Male, Canada, Gestational Age, Infant, Premature, Diseases, Pediatrics, Decision Support Techniques, Risk Factors, Infant Mortality, Humans, Infant, Very Low Birth Weight, Hospital Mortality, Selection Bias, Retrospective Studies, Sweden, Models, Statistical, Infant, Newborn, Australia, Infant, Prognosis, Benchmarking, ROC Curve, Area Under Curve, Infant, Extremely Premature, Infant, Small for Gestational Age, Intensive Care, Neonatal, Female, Infant, Premature, New Zealand
Abstract

© 2017 The Author(s). Background: Compared to very low gestational age (

13. Assessing the association between necrotizing enterocolitis and the type of initial central venous access in preterm infants.

Author

Abda A, Yoon E, Kanungo J, Ojah C, Lapointe A, Shah PS, Beltempo M, and Barrington KJ

Subjects
Humans, Infant, Newborn, Male, Female, Retrospective Studies, Central Venous Catheters adverse effects, Enterocolitis, Necrotizing etiology, Enterocolitis, Necrotizing epidemiology, Infant, Premature, Catheterization, Central Venous adverse effects
Abstract

Aim: Umbilical venous catheters (UVC) have been associated with an increased risk of necrotizing enterocolitis (NEC). We aimed to assess the relationship between the type of initial central venous access in preterm infants and NEC., Methods: Using the Canadian Neonatal Network database, we identified preterm infants <30 weeks gestation born between 2014 and 2021 in one of 32 participating centres who had a peripherally inserted central catheter (PICC) as initial vascular access. These infants were matched in a 1:1 ratio based on gestational age, sex and birth weight to infants in two other groups: (i) those who initially had an UVC and (ii) those who had an UVC followed by a PICC., Results: A total of 497 infants were included in this study: 165 in the PICC group, 164 in the UVC group and 165 in the UVC + PICC group. There was no association between the type of initial central venous access and NEC., Conclusion: Although this retrospective study did not find an association between the type of initial central venous access and NEC, larger prospective studies are required to evaluate this association., (© 2024 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Published
2025
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14. CPAP Versus NIPPV Postextubation in Preterm Neonates: A Comparative-Effectiveness Study.

Author

Mukerji A, Read B, Yang J, Baczynski M, Ng E, Dunn M, Ethier G, Abou Mehrem A, Beltempo M, Drolet C, da Silva O, Louis D, Lemyre B, Afifi J, Singh B, Sherlock R, Stavel M, Masse E, Kanungo J, Wong J, Bodani J, Khurshid F, Lee KS, Augustine S, de Oliveira CB, Makary H, Newman A, Ojah C, and Shah PS

Subjects
Infant, Newborn, Humans, Continuous Positive Airway Pressure, Infant, Premature, Canada, Gestational Age, Intermittent Positive-Pressure Ventilation, Respiratory Distress Syndrome, Newborn therapy
Abstract

Background and Objectives: Nasal intermittent positive pressure ventilation (NIPPV) has been shown to be superior to nasal continuous positive airway pressure (CPAP) postextubation in preterm neonates. However, studies have not permitted high CPAP pressures or rescue with other modes. We hypothesized that if CPAP pressures >8 cmH2O and rescue with other modes were permitted, CPAP would be noninferior to NIPPV., Methods: We conducted a pragmatic, comparative-effectiveness, noninferiority study utilizing network-based real-world data from 22 Canadian NICUs. Centers self-selected CPAP or NIPPV as their standard postextubation mode for preterm neonates <29 weeks' gestation. The primary outcome was failure of the initial mode ≤72 hours. Secondary outcomes included failure ≤7 days, and reintubation ≤72 hours and ≤7 days. Groups were compared using a noninferiority adjusted risk-difference (aRD) margin of 0.05, and margin of no difference., Results: A total of 843 infants extubated to CPAP and 974 extubated to NIPPV were included. CPAP was not noninferior (and inferior) to NIPPV for failure of the initial mode ≤72 hours (33.0% vs 26.3%; aRD 0.07 [0.03 to 0.12], Pnoninferiority(NI) = .86), and ≤7 days (40.7% vs 35.8%; aRD 0.09 [0.05 to 0.13], PNI = 0.97). However, CPAP was noninferior (and equivalent) to NIPPV for reintubation ≤72 hours (13.2% vs 16.1%; aRD 0.01 [-0.05 to 0.02], PNI < .01), and noninferior (and superior) for reintubation ≤7 days (16.4% vs 22.8%; aRD -0.04 [-0.07 to -0.001], PNI < .01)., Conclusions: CPAP was not noninferior to NIPPV for failure ≤72 hours postextubation; however, it was noninferior to NIPPV for reintubation ≤72 hours and ≤7 days. This suggests CPAP may be a reasonable initial postextubation mode if alternate rescue strategies are available., (Copyright © 2024 by the American Academy of Pediatrics.)

Published
2024
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15. The Trend in Costs of Tertiary-Level Neonatal Intensive Care for Neonates Born Preterm at 22 0/7 -28 6/7  Weeks of Gestation from 2010 to 2019 in Canada.

Author

Yeung T, Rios JD, Beltempo M, Khurshid F, Toye J, Ojah C, Zupancic JAF, Lee SK, Pechlivanoglou P, and Shah PS

Subjects
Canada, Female, Gestational Age, Humans, Infant, Infant, Newborn, Infant, Premature, Intensive Care Units, Neonatal, Ontario, Pregnancy, Retrospective Studies, Infant, Premature, Diseases, Intensive Care, Neonatal
Abstract

Objective: To describe the trend in costs over 10 years for tertiary-level neonatal care of infants born 22 0/7 -28 6/7  weeks of gestation during an ongoing Canadian national quality improvement project., Study Design: Clinical characteristics, outcomes, and third-party payor costs for the tertiary neonatal care of infants born 22 0/7 -28 6/7  weeks of gestation between the years 2010 and 2019 were analyzed from the Canadian Neonatal Network database. Costs were estimated using resource use data from the Canadian Neonatal Network and cost inputs from hospitals, physician billing, and administrative databases in Ontario, Canada. Cost estimates were adjusted to 2017 Canadian dollars (CAD). A generalized linear mixed-effects model with gamma regression was used to estimate trends in costs., Results: Between 2010 and 2019, the number of infants born <24 weeks of gestation increased from 4.4% to 7.7%. The average length of stay increased from 68 days to 75 days. Unadjusted average ± SD total costs per neonate were $120 717 ± $93 062 CAD in 2010 and $132 774 ± $93 161 CAD in 2019. After adjustment for year, center, and gestation, total costs and length of stay increased significantly, by $13 612 CAD (P < .01) and 8.1 days (P < .01) over 10 years, respectively; whereas costs accounting for LOS remained stable., Conclusions: The total costs and length of stay for infants 22 0/7 -28 6/7  weeks of gestation have increased over the past decade in Canada during an ongoing national quality improvement initiative; however, there was an increase in the number and survival of neonates at the age of periviability., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Published
2022
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16. Duration of Initial Empirical Antibiotic Therapy and Outcomes in Very Low Birth Weight Infants.

Author

Ting JY, Roberts A, Sherlock R, Ojah C, Cieslak Z, Dunn M, Barrington K, Yoon EW, and Shah PS

Subjects
Cohort Studies, Drug Administration Schedule, Female, Humans, Infant, Newborn, Intensive Care, Neonatal methods, Male, Nervous System Diseases chemically induced, Nervous System Diseases diagnosis, Nervous System Diseases epidemiology, Ontario epidemiology, Retrospective Studies, Treatment Outcome, Anti-Bacterial Agents administration & dosage, Anti-Bacterial Agents adverse effects, Empirical Research, Infant, Very Low Birth Weight physiology, Intensive Care, Neonatal trends
Abstract

: media-1vid110.1542/5984244681001PEDS-VA&#95;2018-2286 Video Abstract BACKGROUND: Overuse of antibiotics can facilitate antibiotic resistance and is associated with adverse neonatal outcomes. We studied the association between duration of antibiotic therapy and short-term outcomes of very low birth weight (VLBW) (<1500 g) infants without culture-proven sepsis., Methods: We included VLBW infants admitted to NICUs in the Canadian Neonatal Network between 2010-2016 who were exposed to antibiotics but did not have culture-proven sepsis in the first week. Antibiotic exposure was calculated as the number of days an infant received antibiotics in the first week of life. Composite primary outcome was defined as mortality or any major morbidity (severe neurologic injury, retinopathy of prematurity, necrotizing enterocolitis, chronic lung disease, or hospital-acquired infection)., Results: Of the 14 207 included infants, 21% ( n = 2950), 38% ( n = 5401), and 41% ( n = 5856) received 0, 1 to 3, and 4 to 7 days of antibiotics, respectively. Antibiotic exposure for 4 to 7 days was associated with higher odds of the composite outcome (adjusted odds ratio 1.24; 95% confidence interval [CI] 1.09-1.41). Each additional day of antibiotic use was associated with 4.7% (95% CI 2.6%-6.8%) increased odds of composite outcome and 7.3% (95% CI 3.3%-11.4%) increased odds in VLBW infants at low risk of early-onset sepsis (born via cesarean delivery, without labor and without chorioamnionitis)., Conclusions: Prolonged empirical antibiotic exposure within the first week after birth in VLBW infants is associated with increased odds of the composite outcome. This practice is a potential target for antimicrobial stewardship., Competing Interests: POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose., (Copyright © 2019 by the American Academy of Pediatrics.)

Published
2019
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17. Predictors of PDA Treatment in Preterm Neonates Who Had Received Prophylactic Indomethacin.

Author

Louis D, ElSayed YN, Ojah C, Alvaro R, Shah PS, and Dunn M

Subjects
Canada, Female, Gestational Age, Humans, Infant, Newborn, Infant, Premature, Intensive Care Units, Neonatal, Male, Retrospective Studies, Cyclooxygenase Inhibitors therapeutic use, Ductus Arteriosus, Patent drug therapy, Ductus Arteriosus, Patent surgery, Indomethacin therapeutic use, Ligation statistics & numerical data
Abstract

Objective:  To identify clinical factors those predict the need for patent ductus arteriosus (PDA) treatment in preterm neonates who had received prophylactic indomethacin., Patients and Methods:  Preterm neonates with <28 weeks' gestational age admitted to level III neonatal intensive care units (NICUs) in Canada between 2010 and 2015 and who had received prophylactic indomethacin were included. Primary outcome was surgical ligation of PDA, while secondary outcomes were any PDA treatment and common neonatal morbidities., Results:  Of the 7,024 eligible neonates, 843 (12%) neonates had received prophylactic indomethacin. Of them, 84 neonates (10%) required surgical ligation while 367 neonates (44%) received medical or surgical treatment for PDA. Logistic regression analyses identified gestational age (odds ratio [OR]: 0.71, 95% confidence interval [CI]: 0.58-0.87) and outborn status (OR: 2.07, 95% CI: 1.09-3.93) as predictors for surgical ligation. Maternal hypertension (OR: 0.57, 95% CI: 0.37-0.89), rupture of membranes (ROM) ≥24 hours (OR: 0.68, 95% CI: 0.48-0.96), and surfactant treatment (OR: 1.70, 95% CI: 1.09-2.66) were predictors for medical or surgical treatment of PDA., Conclusion:  In extremely preterm neonates who had received prophylactic indomethacin, gestational age and outborn status were predictors for surgical ligation of PDA, while maternal hypertension, ROM ≥24 hours, and surfactant treatment were associated with the medical or surgical treatment of PDA., Competing Interests: None., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

Published
2018
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19. Red Blood Cell Transfusions at 21 Days of Age or Older in Previously Transfusion-Naive Very Preterm Infants: Association with Neonatal Outcomes.

Author

Keir A, Aziz K, McMillan D, Monterrosa L, Ojah C, Lee S, and Shah PS

Subjects
Age Factors, Canada, Chi-Square Distribution, Female, Gestational Age, Humans, Infant, Infant, Newborn, Logistic Models, Male, Multivariate Analysis, Retrospective Studies, Erythrocyte Transfusion adverse effects, Infant Mortality, Infant, Extremely Premature blood, Lung Diseases epidemiology, Retinopathy of Prematurity epidemiology
Abstract

Objective: This study aims to assess the association of red blood cell (RBC) transfusion in a cohort of preterm infants with mortality, retinopathy of prematurity (ROP), and chronic lung disease (CLD) transfused at ≥21 days of life., Study Design and Methods: This retrospective cohort study included infants born at <30 weeks' gestation who survived ≥21 days, had not received any RBC transfusions before reaching 21 days of age, and were admitted to participating units in the Canadian neonatal network (2003-2009)., Results: Out of the 3,799 eligible infants, 3,309 infants did not receive RBC transfusion at  ≥21 days of age, whereas 490 received transfusion at  ≥21 days of age. Infants who did not receive RBC transfusion/s at  ≥21 days of age had higher birth weight (p<0.01) and higher gestational age at the time of birth (p<0.01) as compared with those who received transfusion/s at ≥21 days of age. Receipt of RBC transfusion/s at  ≥21 days of age was not associated with mortality (adjusted odds ratio [AOR] 1.20; 95% confidence interval [CI] 0.33-4.34) or severe ROP (AOR 1.02; 95% CI 0.59-1.77) but was associated with increased odds of CLD (AOR 1.78; 95% CI 1.43-2.22)., Conclusion: RBC transfusion/s at  ≥21 days of age in previously transfusion-naive preterm infants was associated with increased odds of CLD but not with ROP or mortality., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

Published
2015
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20. Nil-per-os days and necrotizing enterocolitis in extremely preterm infants.

Author

Kirtsman M, Yoon EW, Ojah C, Cieslak Z, Lee SK, and Shah PS

Subjects
Canada, Case-Control Studies, Female, Gestational Age, Humans, Infant, Newborn, Intensive Care Units, Neonatal, Logistic Models, Male, Risk Factors, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Ductus Arteriosus, Patent drug therapy, Enterocolitis, Necrotizing drug therapy, Fasting adverse effects, Indomethacin therapeutic use, Infant, Extremely Premature
Abstract

Objective: This study aims to evaluate the association between nil-per-os (NPO) days and development of necrotizing enterocolitis (NEC) in extremely preterm neonates (<29 weeks gestational age)., Study Design: A case-control study of 234 extremely preterm neonates who developed stage II or III NEC and 467 matched control infants admitted to participating sites in the Canadian Neonatal Network between 2010 and 2011 was conducted. The number and percentage of NPO days before the development of NEC was compared with the equivalent period in control infants using logistic regression., Results: Infants with NEC were NPO on average 5.6 days (28% of days before NEC) versus 3.7 days (19% of equivalent days; p < 0.01) among controls. NEC cases required more days of inotropic support, antibiotic use, and had higher rates of patent ductus arteriosus (PDA). After adjusting for inotrope use, PDA, antibiotics, and severity of illness, for each additional NPO day the adjusted odds for NEC increased by 1.08 (95% confidence interval: 1.04-1.12)., Conclusion: Among extremely preterm neonates, those who developed NEC were NPO for a longer period of time than control infants who were NEC-free. We speculate that delayed initiation or interruption of feeding may be a potent risk factor for NEC., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

Published
2015
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21. Transport Risk Index of Physiologic Stability, version II (TRIPS-II): a simple and practical neonatal illness severity score.

Author

Lee SK, Aziz K, Dunn M, Clarke M, Kovacs L, Ojah C, and Ye XY

Subjects
Female, Humans, Infant, Newborn, Infant, Premature, Intensive Care Units, Neonatal, Lethargy, Male, Multivariate Analysis, Oximetry, Prognosis, Prospective Studies, ROC Curve, Reproducibility of Results, Blood Pressure, Body Temperature, Hospital Mortality, Respiratory Distress Syndrome, Newborn diagnosis, Severity of Illness Index
Abstract

Objective: Derive and validate a practical assessment of infant illness severity at admission to neonatal intensive care units (NICUs)., Study Design: Prospective study involving 17,075 infants admitted to 15 NICUs in 2006 to 2008. Logistic regression was used to derive a prediction model for mortality comprising four empirically weighted items (temperature, blood pressure, respiratory status, response to noxious stimuli). This Transport Risk Index of Physiologic Stability, version II (TRIPS-II) was then validated for prediction of 7-day and total NICU mortality., Results: TRIPS-II discriminated 7-day (receiver operating curve [ROC] area, 0.90) and total NICU mortality (ROC area, 0.87) from survival. Furthermore, there was a direct association between changes in TRIPS-II at 12 and 24 hours and mortality. There was good calibration across the full range of TRIPS-II scores and the gestational age at birth, and addition of TRIPS-II improved performance of prediction models that use gestational age and baseline population risk variables., Conclusion: TRIPS-II is a validated benchmarking tool for assessing infant illness severity at admission and for up to 24 hours after., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

Published
2013
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22. Neighbourhood income level and outcomes of extremely preterm neonates: protection conferred by a universal health care system.

Author

Ko G, Shah P, Kovacs L, Ojah C, Riley P, and Lee SK

Subjects
Canada epidemiology, Cohort Studies, Female, Humans, Infant, Newborn, Intensive Care Units, Neonatal, Male, Morbidity trends, Population Density, Poverty Areas, Universal Health Insurance, Income statistics & numerical data, Infant Mortality trends, Infant, Extremely Premature, Infant, Premature, Diseases epidemiology, Residence Characteristics statistics & numerical data
Abstract

Objectives: To determine the impact of neighbourhood income and maternal residence population density on mortality and various morbidities at discharge or transfer from the NICU among extremely preterm neonates (<27 weeks gestation) in Canada., Methods: Neighbourhood income level and residential status was derived using a postal code conversion file and census data. Multivariable logistic regression analysis was used to estimate the risk-adjusted odds ratio (AOR) of mortality and survival without major morbidities (chronic lung disease, necrotizing enterocolitis, severe intraventricular hemorrhage, and retinopathy of prematurity) among 2,752 extremely preterm infants admitted to 25 tertiary level neonatal intensive care units in Canada between 2007 and 2008., Results: There were no significant differences between mothers from different neighbourhood income quintiles (Q1 = low; Q5 = high) and neonatal mortality AOR (95% confidence interval): Q1: 1.10 (0.74-1.62), Q2: 1.00 (0.67-1.49), Q3: 1.39 (0.93-2.07), Q4: 1.01 (0.67-1.52), Q5: 1 (reference); or survival without major morbidity: Q1: 1.01 (0.70-1.44), Q2: 0.84 (0.58-1.23), Q3: 0.85 (0.58-1.24), Q4: 0.92 (0.63-1.35), Q5: 1 (reference). There were no significant differences in mortality (AOR 1.14 [0.83-1.57]) or in survival without major morbidity (AOR 0.92 [0.67-1.26]) between infants of mothers residing in sparsely populated areas compared to densely populated areas., Conclusion: Maternal residence in a low-income neighbourhood or sparsely populated area was not associated with higher odds of mortality or survival free of major morbidities in extremely preterm infants.

Published
2012

23. Comparison of the safety and immunogenicity of concomitant and sequential administration of an adult formulation tetanus and diphtheria toxoids adsorbed combined with acellular pertussis (Tdap) vaccine and trivalent inactivated influenza vaccine in adults.

Author

McNeil SA, Noya F, Dionne M, Predy G, Meekison W, Ojah C, Ferro S, Mills EL, Langley JM, and Halperin SA

Subjects
Adult, Antibodies, Bacterial blood, Antibodies, Viral blood, Diphtheria Toxoid adverse effects, Diphtheria-Tetanus-acellular Pertussis Vaccines adverse effects, Female, Humans, Influenza Vaccines adverse effects, Male, Middle Aged, Tetanus Toxoid adverse effects, Vaccines, Combined adverse effects, Vaccines, Combined immunology, Vaccines, Inactivated adverse effects, Vaccines, Inactivated immunology, Diphtheria Toxoid immunology, Diphtheria-Tetanus-acellular Pertussis Vaccines immunology, Influenza Vaccines immunology, Tetanus Toxoid immunology
Abstract

The annual contact for influenza vaccination provides an opportunity to ensure that adults have received other recommended vaccines such as Tdap. Healthy 19-64 year-olds were randomized to receive concomitant administration of Tdap and influenza vaccines or influenza vaccine followed (in 4-6 weeks by) Tdap. 720 participants were enrolled. No clinically relevant between-group differences were observed in the rates or severities of erythema, swelling, or pain at the Tdap injection site. Injection-site pain was the most commonly reported adverse event (66.6% concomitant administration group versus 60.8% sequential administration group); most pain was graded as mild and resolved by day 3. Seroprotection and seroresponse rates for all influenza strains were comparable between the two groups. For diphtheria and tetanus, seroprotection rates and post-vaccination GMTs were non-inferior in the concomitant administration group compared to the sequential administration group. A trend for lower antibody responses to pertussis antigens PT, FHA, and FIM was observed after concomitant administration and, for PRN, this difference failed the non-inferiority criteria. While there is a small diminution in antibody response to tetanus and pertussis antigens, concomitant administration of Tdap and influenza vaccine was well tolerated and immunogenic and may offer practical advantages including convenience, compliance, and cost-savings.

Published
2007
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24. The Pediatric Investigators Collaborative Network on Infections in Canada study of predictors of hospitalization for respiratory syncytial virus infection for infants born at 33 through 35 completed weeks of gestation.

Author

Law BJ, Langley JM, Allen U, Paes B, Lee DS, Mitchell I, Sampalis J, Walti H, Robinson J, O'Brien K, Majaesic C, Caouette G, Frenette L, Le Saux N, Simmons B, Moisiuk S, Sankaran K, Ojah C, Singh AJ, Lebel MH, Bacheyie GS, Onyett H, Michaliszyn A, Manzi P, and Parison D

Subjects
Antibodies, Monoclonal therapeutic use, Antibodies, Monoclonal, Humanized, Canada epidemiology, Cohort Studies, Female, Gestational Age, Humans, Infant, Newborn, Logistic Models, Male, Multivariate Analysis, Palivizumab, Predictive Value of Tests, Pregnancy, Prevalence, Probability, Respiratory Syncytial Virus Infections drug therapy, Risk Assessment, Severity of Illness Index, Sex Factors, Survival Rate, Treatment Outcome, Hospitalization statistics & numerical data, Infant, Premature, Respiratory Syncytial Virus Infections diagnosis, Respiratory Syncytial Virus Infections epidemiology
Abstract

Background: Infants born at 33 through 35 completed weeks of gestation (33-35GA) are at risk for severe respiratory syncytial virus (RSV) infection, and palivizumab prophylaxis lowers hospitalizations for RSV infection by as much as 80%. The 33-35GA cohort comprises 3-5% of annual births; thus expert panels recommend limiting prophylaxis to situations in which frequency or health care impact of RSV infection is high. This study sought to identify independent risk factors for hospitalization for RSV infection., Methods: This was a multicenter, prospective, observational cohort study of 33-35GA infants followed through their first RSV season (2001/2002 or 2002/2003). Baseline data were collected by interview with parents and review of medical records. Respiratory tract illnesses were identified by monthly phone calls, and medical records were reviewed for emergency room visits or hospitalizations. Risk factors were determined by stepwise logistic regression., Results: Of 1,860 enrolled subjects, 1,832 (98.5%) were followed for at least 1 month, and 1,760 (94.6%) completed all follow-ups. Of 140 (7.6%) subjects hospitalized for respiratory tract illnesses, 66 infants had proven RSV infection. Independent predictors for hospitalization for RSV infection were: day-care attendance (odds ratio, 12.32; 95% confidence interval, 2.56, 59.34); November through January birth (odds ratio, 4.89; 95% confidence interval, 2.57, 9.29); preschool age sibling(s) (odds ratio, 2.76; 95% confidence interval, 1.51, 5.03); birth weight <10th percentile (odds ratio, 2.19; 95% confidence interval, 1.14, 4.22); male gender (odds ratio, 1.91; 95% confidence interval, 1.10, 3.31); > or = 2 smokers in the home (odds ratio, 1.87; 95% confidence interval, 1.07, 3.26); and households with >5 people, counting the subject (odds ratio, 1.79; 95% confidence interval, 1.02, 3.16). Family history of eczema (odds ratio, 0.42; 95% confidence interval, 0.18, 0.996) was protective., Conclusions: Specific host/environmental factors can be used to identify which 33-35GA infants are at greatest risk of hospitalization for RSV infection and likely to benefit from palivizumab prophylaxis.

Published
2004
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