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Wide variation in severe neonatal morbidity among very preterm infants in European regions

Anna Karin Edstedt Bonamy1,2, Jennifer Zeitlin3, Aurélie Piedvache3

  • 1Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|January 22, 2018
PubMed

Insights

Severe neonatal morbidity rates for very preterm infants varied significantly across European regions. These rates were not correlated with regional mortality rates, indicating independent factors influence outcomes.

Area of Science:

  • Neonatalogy
  • Perinatal Epidemiology
  • Public Health

Background:

  • Very preterm (VPT) infants face significant risks of severe neonatal morbidity.
  • Variations in care and outcomes exist across different geographical regions.
  • Understanding regional differences in morbidity and mortality is crucial for improving neonatal care.

Purpose of the Study:

  • To investigate the geographical variation in severe neonatal morbidity among very preterm infants in Europe.
  • To determine if higher morbidity rates are associated with regions having lower mortality rates.

Main Methods:

  • An area-based cohort study included all births before 32 weeks of gestational age across 16 European regions.
  • Severe neonatal morbidity was defined using standardized criteria (IVH, PVL, NEC, ROP).
  • Data from 6422 survivors were analyzed, correlating regional morbidity with adjusted in-hospital mortality rates.

Main Results:

  • Severe neonatal morbidity occurred in 10.6% (without BPD) to 13.8% (with BPD) of VPT survivors.
  • Significant regional variations in morbidity (6.4%-23.5%) and mortality (8.4%-18.8%) were observed.
  • Morbidity rates did not correlate with mortality rates after adjusting for confounding factors (P=0.50).

Conclusions:

  • Wide variations in severe neonatal morbidity exist among very preterm infants across European regions.
  • Regional differences in severe neonatal morbidity are independent of regional mortality rates.
  • Further research is needed to identify factors driving these regional disparities in neonatal outcomes.
Abstract

Keywords:
epidemiologymortalityneonatology

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