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Preterm outcome table (POT): a simple tool to aid counselling parents of very preterm infants
Srinivas Bolisetty1, Barbara Bajuk, M E Abdel-Latif
1Department of Newborn Care, Royal Hospital for Women, New South Wales, Australia. srinivas.bolisetty@sesiahs.health.nsw.gov.au
Insights
Simplified outcome data for very premature births aids parental counseling. The Preterm Outcome Table (POT) offers realistic survival and neurodevelopmental information for clinicians.
Area of Science:
- Neonatalogy and Perinatal Medicine
- Clinical Pediatrics
- Public Health Data Analysis
Background:
- Scientific outcome data for premature births is often complex for parents.
- Effective counseling requires clear, accessible information for families facing very premature birth.
Purpose of the Study:
- To develop a simplified, up-to-date outcome table for counseling parents of very premature infants.
- To present perinatal mortality and neonatal intensive care unit (NICU) outcomes in an understandable format.
Main Methods:
- Utilized regional perinatal data (2000-2001) for births between 23-31 weeks gestation.
- Collected neurodevelopmental outcomes at 2-3 years, corrected for prematurity.
- Rounded outcome percentages to the nearest conservative multiple of 5 for simplification.
Main Results:
- The Preterm Outcome Table (POT) included 2315 births; 17.3% were stillborn (23-25 weeks).
- Hospital survival rates for NICU admissions increased with gestational age, reaching >95% for 30-31 weeks.
- 15% of survivors had moderate to severe functional disability at 2-3 years.
Conclusions:
- The POT provides a simple, user-friendly tool for clinicians.
- Realistic data in the POT assists clinicians in counseling parents regarding very premature birth outcomes.
Background:
Outcome figures published in scientific journals are often cumbersome and difficult to understand by parents during counselling before or immediately after a very premature birth.
Aim:
To provide simplified up-to-date outcome information in a table for ease of counselling.
Methods:
Regional perinatal mortality rates for very premature births (23-31 weeks gestation) and incidence of significant neonatal events for those admitted to neonatal intensive care units (NICU) were obtained from the NSW Midwives Data Collection, ACT Maternal and Perinatal Data Collection and the NSW and ACT NICUS Data Collection for 2000 and 2001. Neurodevelopmental outcome was obtained for the same cohort at 2-3 years of age, corrected for prematurity. The percentage outcomes were rounded off to the closest conservative multiple of 5 for each data point in a table.
Results:
The preterm outcome table (POT) for each gestational week was constructed from a total of 2315 births. Of these, 401 (17.3%) were reported as stillborn and were predominantly of 23 to 25 weeks gestation. Of those admitted to NICU, hospital survival rates were 30, 50, 65, 75, 80, 90 and > 95% for 23, 24, 25, 26, 27, 28-29 and 30-31 weeks, respectively. Neurodevelopmental outcome was available for 470 (75%) children, of whom 15% had a moderate to severe functional disability at 2-3 years of age, corrected for prematurity. Simplified data on survival to discharge and outcome were tabulated.
Conclusion:
POT appears simple and easy to use but also provides realistic data to assist clinicians in the counselling process.
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