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[Development of the mortality in premature infants from 32 weeks gestation and below in Fort-de-France]
1Unité de Néonatologie et de Soins Intensifs Néonatals et pédiatriques, CHRU de Fort-de-France.
Insights
Neonatal intensive care unit mortality for premature infants under 32 weeks decreased significantly from 69% in 1980 to 20% in 1989. Further improvements are needed for infants under 27 weeks gestational age.
Area of Science:
- Neonatology
- Perinatology
- Public Health
Context:
- The study examines trends in neonatal intensive care unit (NICU) mortality rates for premature infants.
- Data were collected from the University Hospital in Fort-de-France, Martinique, between 1980 and 1989.
- Focus is on infants with gestational age less than or equal to 32 weeks and small for gestational age (SGA) infants.
Purpose:
- To analyze the changes in mortality rates of premature infants over a decade.
- To identify factors contributing to the observed changes in mortality.
- To compare local outcomes with data from mainland France.
Summary:
- Mortality for premature infants (gestational age ≤32 weeks) in the NICU decreased from 69% in 1980 to 20% in 1989.
- Increased rates of cesarean sections and assisted ventilation correlated with improved survival.
- Mortality related to hyaline membrane disease significantly decreased.
- SGA infants had twice the mortality rate of normal birth weight infants.
Impact:
- Significant improvements in neonatal intensive care have reduced premature infant mortality.
- Outcomes for premature infants ≥27 weeks gestational age are comparable to those in Paris.
- Continued focus is required to improve survival rates for the most premature infants (<27 weeks gestational age).
Abstract:
The mortality rate of prematures of gestational age less than or equal to 32 weeks during hospitalization in the neonatal intensive care unit of the University Hospital in Fort-de-France (Martinique, French Caribbeans) decreased from 69% in 1980 to 32% in 1987-1988 and to 20% in 1989. The mortality of small for gestational age children during the cumulated years 1987-1988-1989 was twice that of babies with normal birth weight. The various factors responsible for these facts were reviewed: caesarean section rates increased from 15% in 1980 to 42% in 1989, percentage of children submitted to assisted ventilation increased from 35% in 1980 to 78% in 1989 and mortality rate related to hyaline membrane disease decreased from 100% in 1980 to 33% in 1989. The comparison with a survey performed in 1985 in the Paris area showed no significant difference with the mortality rate of premature infants of gestational age greater than or equal to 27 weeks born in the University Hospital in Fort-de-France. Therefore an important effort remains necessary concerning mostly children under 27 weeks of gestational age.