Population-based trends in mortality and neonatal morbidities among singleton, very preterm, very low birth weight

Sorina Grisaru-Granovsky1, Brian Reichman2, Liat Lerner-Geva2

  • 1Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Jerusalem, affiliated with the Hebrew University Medical School of Jerusalem.

Early Human Development
|December 3, 2014
PubMed

Insights

Improved survival for very preterm, very low birth weight infants did not increase neurological morbidities. However, bronchopulmonary dysplasia remains a significant concern, requiring targeted interventions.

Area of Science:

  • Neonatalogy
  • Perinatal Medicine
  • Public Health

Background:

  • Improved survival rates for singleton very preterm, very low birth weight (VPT-VLBW) infants have been observed.
  • This improved survival has raised concerns about a potential increase in severe neonatal morbidities.

Purpose of the Study:

  • To evaluate trends in mortality and major neonatal morbidities among singleton VPT-VLBW infants.
  • To determine if increased survival is associated with a higher incidence of neurological complications.

Main Methods:

  • A population-based observational study utilizing data from the Israel Neonatal Network.
  • Analysis of 10,705 singleton VPT-VLBW infants born between 24-32 gestational weeks from 1995-2010.
  • Assessment of mortality and major neonatal morbidities (including neurological complications and bronchopulmonary dysplasia) across three time periods: 1995-2000, 2001-2005, and 2006-2010.

Main Results:

  • Mortality rates significantly decreased from 20.2% to 13.8% over the study period.
  • The incidence of major neurological morbidities among surviving infants decreased from 16.4% to 12.8%.
  • While neurological outcomes improved, bronchopulmonary dysplasia rates remained a considerable challenge.

Conclusions:

  • Increased survival of singleton VPT-VLBW infants is not linked to a higher risk of major neonatal neurological morbidities.
  • Bronchopulmonary dysplasia continues to represent a significant burden for this population.
  • Future research and clinical efforts should focus on preventing and treating respiratory complications in preterm infants.
Abstract

Related Concept Videos

Regression Toward the Mean01:52

Regression Toward the Mean

Regression toward the mean (“RTM”) is a phenomenon in which extremely high or low values—for example, and individual’s blood pressure at a particular moment—appear closer to a group’s average upon remeasuring. Although this statistical peculiarity is the result of random error and chance, it has been problematic across various medical, scientific, financial and psychological applications. In particular, RTM, if not taken into account, can interfere when...
7.3K
Development of the Oral Microbiota01:28

Development of the Oral Microbiota

The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...
48
Teratogenicity01:07

Teratogenicity

The ability of a drug to produce structural deformations and functional abnormalities in the developing embryo or the fetus is called teratogenicity, and the drug producing this effect is known as a teratogen. Teratogenic effects include stillbirth, miscarriage, intrauterine growth restriction, and neurocognitive delay. A teratogen may affect the embryo at different stages of development, which is important in determining the type and extent of the damage. During blastocyst formation, the early...
4.6K
Pharmacokinetics in Pediatric Patients: Drug Distribution01:17

Pharmacokinetics in Pediatric Patients: Drug Distribution

Drug distribution in the pediatric population exhibits unique challenges and considerations due to the physiological differences between children, particularly neonates and infants, and adults. A crucial aspect of pediatric pharmacology is understanding how these differences impact the pharmacokinetics of various drugs, necessitating age-specific dosing strategies to ensure efficacy and safety.Neonates and infants have a higher total body water content, ~75%–90% of their body weight,...
513
Prevalence and Incidence01:08

Prevalence and Incidence

In statistical epidemiology and health sciences, two essential metrics—prevalence and incidence—are fundamental for understanding disease dynamics within a population. These measures enable public health officials, epidemiologists, and researchers to assess the burden of diseases, allocate resources effectively, and design impactful public health policies and interventions.
Prevalence indicates the proportion of individuals in a population who have a specific disease or health...
2.5K