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Wide variation in severe neonatal morbidity among very preterm infants in european regions

Anna-Karin Edstedt Bonamy 1 Jennifer Zeitlin 2 Aurelie Piedvache 2 Rolf F. Maier 3 Arno van Heijst 4 Heili Varendi 5 Bradley N. Manktelow 6 Alan Fenton 7 Jan Mazela 8 Marina Cuttini 9 Mikael Norman 1 Stavros Petrou 10 Patrick van Reempts 11 Henrique Barros 12 Elizabeth S. Draper 6 E. Martens G. Martens K. Boerch 13 A. Hasselager L. Huusom 13 O. Pryds 13 Tom Weber 13 Liis Toome 5 Pierre-Yves Ancel 14 Béatrice Blondel 14 Antoine Burguet 15 Pierre-Henri Jarreau 14 Patrick Truffert 16 S. Schmidt Ludwig Gortner 17 D. Baronciani G. Gargano R. Agostino D. Dilallo F. Franco V. Carnielli 18 C. Koopman-Esseboom 19 J. Nijman Janusz Gadzinowski 9 L. M. Graca M. C. Machado 20 Carina Rodrigues 12 T. Rodrigues 21 Emilija Wilson 22 Eileen Mary Boyle D. W. A. Milligan 23 Mercedes Bonet
1 Karolinska Institutet [Stockholm]
2 CRESS (U1153 / UMR_A_1125 / UMR_S_1153) - Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité
3 Philipps University of Marburg
4 Radboud University Medical Center [Nijmegen]
5 University of Tartu
6 University of Leicester
7 Newcastle University [Newcastle]
8 IRCCS Ospedale Pediatrico Bambino Gesù [Roma]
9 PUMS - Poznan University of Medical Sciences [Poland]
10 University of Warwick [Coventry]
11 UA - University of Antwerp
12 Universidade do Porto
13 Hvidovre Hospital
14 UPD5 - Université Paris Descartes - Paris 5
15 CHU Dijon
16 METRICS - Evaluation des technologies de santé et des pratiques médicales - ULR 2694
17 Saarland University [Saarbrücken]
18 Istituto Nazionale di Riposo e Cura per Anziani di Ancona
19 University Medical Center [Utrecht]
20 Université de Lisbonne
21 Hospital de São João [Porto]
22 Karolinska University Hospital [Stockholm]
23 Royal Victoria Hospital
Abstract : OBJECTIVE: 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. METHODS: Area-based cohort study of all births before 32 weeks of gestational age. METHODS: 16 regions in 11 European countries in 2011/2012. METHODS: Survivors to discharge from neonatal care (n=6422). METHODS: 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. RESULTS: 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). CONCLUSIONS: Severe neonatal morbidity rates for VPT survivors varied widely across European regions and were independent of mortality rates.
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Soumis le : lundi 8 juin 2020 - 11:35:57
Dernière modification le : mardi 2 mars 2021 - 14:48:12

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Anna-Karin Edstedt Bonamy, Jennifer Zeitlin, Aurelie Piedvache, Rolf F. Maier, Arno van Heijst, et al.. Wide variation in severe neonatal morbidity among very preterm infants in european regions. Archives of disease in childhood.Fetal and neonatal edition, BMJ Publishing Group, 2019, Archives of disease in childhood. Fetal and neonatal edition, 104, pp.F36-F45. ⟨10.1136/archdischild-2017-313697⟩. ⟨hal-02860041⟩

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