Thirteen-year mortality and morbidity in preterm infants in Switzerland.

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:
University Hospital Berne,
Department of Neonatology (M Nelle), Department of Pediatrics (B Wagner)

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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