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Deaths in preterm infants: changing pathology over 2 decades

Janet Elizabeth Berrington1, Richard Iain Hearn, Mary Bythell

  • 1Newcastle Neonatal Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK. janet.berrington@nuth.nhs.uk

The Journal of Pediatrics
|August 27, 2011
PubMed

Insights

Infection and necrotizing enterocolitis (NEC) are growing causes of death in preterm infants, while respiratory issues have declined. This trend emerged over two decades in a UK population study.

Area of Science:

  • Neonatal Medicine
  • Pediatric Mortality Studies
  • Public Health Surveillance

Background:

  • Preterm infants (24-31 weeks gestation) face significant mortality risks.
  • Understanding evolving causes of death is crucial for improving neonatal care.
  • Longitudinal data analysis can reveal trends in infant mortality.

Purpose of the Study:

  • To analyze changes in causes of death for live-born preterm infants over a 20-year period.
  • To identify shifts in mortality etiologies within specific gestational age groups.
  • To inform strategies for reducing preterm infant mortality.

Main Methods:

  • Population-based survey of over 680,000 live births in the UK (1988-2008).
  • Analysis of deaths within the first postnatal year, categorized by major etiologies: respiratory, infection, malformation, necrotizing enterocolitis (NEC), and other.
  • Data stratified into three 7-year epochs and two gestational age groups (<27 and 28-31 weeks) for trend analysis.

Main Results:

  • Total deaths decreased over the study period (671 to 360).
  • Proportion of deaths from respiratory causes significantly decreased (64% to 49%).
  • Proportion of deaths from infection and necrotizing enterocolitis (NEC) increased (11% to 21%), with a longer median time to death.

Conclusions:

  • Infection and necrotizing enterocolitis (NEC) have become increasingly prevalent causes of mortality in preterm infants.
  • The declining proportion of respiratory deaths suggests improvements in respiratory support for preterm neonates.
  • Shifting mortality patterns necessitate updated clinical focus and interventions for preterm infant survival.
Abstract

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