Preterm birth in the Nordic countries—Capacity, management and outcome in neonatal careDepartment of Paediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland; Department of Clinical Medicine, University of Turku, Turku, Finland.
The Danish Clinical Quality Program – National Clinical Registries (RKKP), Aarhus, Denmark; Department of Obstetrics and Gynaecology, Aalborg University Hospital, Thisted, Denmark.
The Danish Clinical Quality Program – National Clinical Registries (RKKP), Aarhus, Denmark.
Department of Knowledge Brokers, THL Finnish Institute for Health and Welfare, Helsinki, Finland.
Department of Knowledge Brokers, THL Finnish Institute for Health and Welfare, Helsinki, Finland.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
Department of Neonatal Medicine, Karolinska University Hospital, Stockholm, Sweden; Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Paediatric Research Group, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway; Department of Paediatrics and Adolescence Medicine, University Hospital of North Norway, Tromsø, Norway.
Department of Paediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland; Department of Clinical Medicine, University of Turku, Turku, Finland.
Department of Paediatrics, New Children's Hospital, Paediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Department of Neonatal Intensive Care, Clinic of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway; Medical Faculty, Institute for Clinical Medicine, University of Oslo, Oslo, Norway.
The Danish Clinical Quality Program – National Clinical Registries (RKKP), Aarhus, Denmark; Department of Intensive Care of Newborns and Small Children, University Hospital of Copenhagen, Copenhagen, Denmark.
Show others and affiliations
2023 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 112, no 7, p. 1422-1433Article in journal (Refereed) Published
Abstract [en]
Aim: Organisation of care, perinatal and neonatal management of very preterm infants in the Nordic regions were hypothesised to vary significantly. The aim of this observational study was to test this hypothesis.
Methods: Information on preterm infants in the 21 greater healthcare regions of Denmark, Finland, Iceland, Norway and Sweden was gathered from national registers in 2021. Preterm birth rates, case-mix, perinatal interventions, neonatal morbidity and survival to hospital discharge in very (<32 weeks) and extremely preterm infants (<28 weeks of gestational age) were compared.
Results: Out of 287 642 infants born alive, 16 567 (5.8%) were preterm, 2389 (0.83%) very preterm and 800 (0.28%) were extremely preterm. In very preterm infants, exposure to antenatal corticosteroids varied from 85% to 98%, live births occurring at regional centres from 48% to 100%, surfactant treatment from 28% to 69% and use of mechanical ventilation varied from 13% to 77% (p < 0.05 for all comparisons). Significant regional variations within and between countries were also seen in capacity in neonatal care, case-mix and number of admissions, whereas there were no statistically significant differences in survival or major neonatal morbidities.
Conclusion: Management of very preterm infants exhibited significant regional variations in the Nordic countries.
Place, publisher, year, edition, pages
John Wiley & Sons, 2023. Vol. 112, no 7, p. 1422-1433
Keywords [en]
gestational age, mortality, neonatal care, Nordic country, premature
National Category
Pediatrics
Identifiers
URN: urn:nbn:se:umu:diva-206347DOI: 10.1111/apa.16753ISI: 000957038000001PubMedID: 36912750Scopus ID: 2-s2.0-85150900950OAI: oai:DiVA.org:umu-206347DiVA, id: diva2:1753513
Funder
Stiftelsen Frimurare Barnhuset i StockholmRegion Stockholm, 2020-0443Karolinska Institute, 2020-04432023-04-272023-04-272023-07-13Bibliographically approved