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[Epipage study: mortality of very premature infants and state of progress at follow up]
1INSERM U149, Unité de Recherche en Santé Périnatale et Santé des Femmes, 16, avenue Paul-Vaillant-Couturier, 94807 Villejuif.
Insights
This study on very preterm infants found survival rates increase with gestational age. Lower survival was observed for low birth weight and multiple births, highlighting key risk factors.
Area of Science:
- Neonatal research
- Perinatal epidemiology
- High-risk obstetrics
Context:
- The Epipage study in 1997 French regions included infants born between 22 and 32 weeks gestational age.
- This research focuses on perinatal and neonatal mortality within this vulnerable population.
Purpose:
- To investigate perinatal and neonatal mortality rates in very preterm infants.
- To analyze the association between mortality and factors such as birth weight and multiple births.
Summary:
- A total of 4397 births were analyzed, with a 67% survival rate for all births (including stillbirths) and 85% for livebirths.
- Survival rates increased significantly with gestational age, reaching 97% by 32 weeks.
- Infants with birth weights below the 10th percentile and those from multiple pregnancies had lower survival rates.
Impact:
- Provides crucial mortality data for very premature infants from pregnancy through hospitalization.
- Offers insights into survival trends stratified by gestational age, comparable to other international studies.
- Informs clinical practice and public health strategies for managing high-risk pregnancies and neonates.
Objective:
To study perinatal and neonatal mortality of very preterm infants and to assess the association with birth weight and multiple births.
Methods:
Infants enrolled in the Epipage study born between 22 and 32 weeks gestational age in 9 French regions in 1997 were included in this study. The main outcome measure was stillbirth and death before discharge from hospital.
Results:
During the study period, 4397 births and therapeutic abortions meeting the inclusion criteria were recorded (including 16% therapeutic abortions and 18% stillbirths). Survival rate for babies born between 22 and 32 weeks was 67% of all births (stillborn + liveborn) and 85% among livebirths. Survival rose with increasing gestational age: survival (livebirths) was 50% at 25 weeks gestation, 78% at 28 weeks and 97% at 32 weeks. Survival was lower for infants with a birthweight below the 10th percentile and for multiple-pregnancy infants. The different stages of the follow-up planned up to 5 years are presented together with the response rate to the postal follow-up questionnaire.
Conclusion:
This cohort provides mortality data on very premature infants during pregnancy, at birth, during hospitalization before discharge. Survival of liveborn infants was stratified by gestational age and was consistent with other geographically based studies of very preterm infants born in the 1990s.
