Chen, Fei; Bajwa, Nadia M; Rimensberger, Peter C; Posfay-Barbe, Klara M; Pfister, Riccardo E; Swiss Neonatal, Network (2016). Thirteen-year mortality and morbidity in preterm infants in Switzerland. Archives of disease in childhood, 101(5), F377-F383. BMJ Publishing Group 10.1136/archdischild-2015-308579
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OBJECTIVE
To report the population-based, gestational age (GA)-stratified mortality and morbidity for very preterm infants over 13 years in Switzerland.
DESIGN
A prospective, observational study including 95% of Swiss preterm infants (GA <32 weeks) during three time periods: 2000-2004 (P1), 2005-2008 (P2) and 2009-2012 (P3).
SETTING
The Swiss Neonatal Network, covering all level III neonatal intensive care units (NICUs) and affiliated paediatric hospitals.
PATIENTS
8899 live-born preterm infants with GA <32 weeks.
MAIN OUTCOME MEASURES
Trends in GA-specific mortality (overall, delivery room and NICU), 'survival free of major complications' and major short-term morbidities: bronchopulmonary dysplasia (BPD, oxygen requirement at 36 weeks), grades 3 and 4 intraventricular haemorrhage (IVH 3-4), necrotising enterocolitis (NEC) and cystic periventricular leukomalacia (cPVL).
RESULTS
Survival rate was 84.4%; 5.7% died in the delivery room and 9.9% died in the NICU. Neonatal mortality was 8.6% and post-neonatal mortality in NICU admissions was 1.3%. Reductions were observed in overall mortality from 18.4% (95% CI 17.0% to 19.8%) in P1 to 13.8% (13% to 15%) in P3, NICU mortality from 12.6% (11.4% to 13.8%) to 8.2% (7.2% to 9.2%) and IVH 3-4 from 7.8% (6.8% to 8.7%) to 5.8% (4.9% to 6.6%). There was no change in the incidence of cPVL and NEC. The BPD (oxygen requirement at 36 weeks) incidence displayed a U-shaped distribution across the three time periods. Overall, 71.0% (70.0% to 72.0%) had 'survival free of major complications' at the time of hospital discharge, and this significantly improved from 66.7% (65.0% to 68.4%) to 72.4% (70.8% to 74.0%) between P1 and P3.
CONCLUSIONS
Survival rates of very preterm infants increased with decreasing delivery room and neonatal mortalities, mostly in extremely preterm infants. The incidence of IVH 3-4 decreased, whereas the incidences of cPVL, NEC and BPD (oxygen requirement at 36 weeks) remained largely unchanged from 2000 to 2012 in Switzerland.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine 04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine > Paediatric Intensive Care 04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine > Neonatology |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0003-9888 |
Publisher: |
BMJ Publishing Group |
Language: |
English |
Submitter: |
Anette van Dorland |
Date Deposited: |
24 May 2017 11:15 |
Last Modified: |
20 Jul 2022 10:01 |
Publisher DOI: |
10.1136/archdischild-2015-308579 |
PubMed ID: |
27059074 |
Additional Information: |
Collaborators: The following investigators and hospitals from the Univeristy of Berne participated in the Swiss Neonatal Network: |
Uncontrolled Keywords: |
Epidemiology; Mortality; Neonatology; Pathology; Qualitative research |
BORIS DOI: |
10.7892/boris.96459 |
URI: |
https://boris.unibe.ch/id/eprint/96459 |
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