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Neonatal Outcomes of Very Low Birth Weight and Very Preterm Neonates: An International Comparison
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2016 (English)In: Journal of Pediatrics, ISSN 0022-3476, E-ISSN 1097-6833, Vol. 177, 144-152 p.Article in journal (Refereed) Published
Abstract [en]

Objective To compare rates of a composite outcome of mortality or major morbidity in very-preterm/very low birth weight infants between 8 members of the International Network for Evaluating Outcomes.

Study design We included 58 004 infants born weighing < 1500 g at 24 degrees-31(6) weeks' gestation from databases in Australia/New Zealand, Canada, Israel, Japan, Spain, Sweden, Switzerland, and the United Kingdom. We compared a composite outcome (mortality or any of grade >= 3 peri-intraventricular hemorrhage, periventricular echodensity/echolucency, bronchopulmonary dysplasia, or treated retinopathy of prematurity) between each country and all others by using standardized ratios and pairwise using logistic regression analyses.

Results Despite differences in population coverage, included neonates were similar at baseline. Composite outcome rates varied from 26% to 42%. The overall mortality rate before discharge was 10% (range: 5% [Japan]-17% [Spain]). The standardized ratio (99% CIs) estimates for the composite outcome were significantly greater for Spain 1.09 (1.04-1.14) and the United Kingdom 1.16 (1.11-1.21), lower for Australia/New Zealand 0.93 (0.89-0.97), Japan 0.89 (0.86-0.93), Sweden 0.81 (0.73-0.90), and Switzerland 0.77 (0.69-0.87), and nonsignificant for Canada 1.04 (0.99-1.09) and Israel 1.00 (0.93-1.07). The adjusted odds of the composite outcome varied significantly in pairwise comparisons.

Conclusions We identified marked variations in neonatal outcomes between countries. Further collaboration and exploration is needed to reduce variations in population coverage, data collection, and case definitions. The goal would be to identify carepractices and health care organizational factors, which has the potential to improve neonatal outcomes.

Place, publisher, year, edition, pages
2016. Vol. 177, 144-152 p.
National Category
Pediatrics
Identifiers
URN: urn:nbn:se:umu:diva-130252DOI: 10.1016/j.jpeds.2016.04.083ISI: 000390022700032PubMedID: 27233521OAI: oai:DiVA.org:umu-130252DiVA: diva2:1065725
Available from: 2017-01-16 Created: 2017-01-14 Last updated: 2017-05-30Bibliographically approved

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CiteExportLink to record
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Cite
Citation style
  • apa
  • ieee
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More styles
Language
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Output format
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