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Improved survival of very preterm born infants from 2000 to 2013 in Denmark
Vilde Victoria Løgavlen, Mattis Sundhagen Mikkelsen, Gitte Zachariassen1
1Gitte.Zachariassen@rsyd.dk.
Insights
Survival rates for very preterm infants improved, particularly for those born at 26-27 weeks gestational age (GA). Major neonatal morbidities did not significantly increase, indicating successful treatment advancements for high-risk newborns.
Area of Science:
- Neonatal Intensive Care
- Perinatal Medicine
- Pediatric Critical Care
Background:
- Improved survival rates in very preterm infants are noted, but concerns exist regarding potential increases in neonatal morbidity due to advanced treatment strategies.
- This study investigates survival and major morbidities in very and extremely preterm infants within a Danish neonatal intensive care unit.
Purpose of the Study:
- To assess survival rates and major neonatal morbidities in very preterm infants.
- To compare outcomes between two distinct birth-year periods (2000-2007 and 2008-2013) due to changes in treatment protocols.
Main Methods:
- Observational cohort study of very preterm infants (gestational age < 32 weeks) born between 2000 and 2013.
- Comparison of survival and major neonatal morbidity between two periods: 2000-2007 and 2008-2013, to evaluate the impact of treatment changes implemented in 2008.
Main Results:
- Overall survival rate increased from 81.6% to 85.0%.
- Survival in the 26-27 weeks gestational age group significantly increased from 65% to 89% (p=0.02).
- No significant differences were observed in rates of bronchopulmonary dysplasia, necrotising entrocolitis, or intraventricular haemorhage between the two periods. Antibiotic use for suspected infections increased in the later period.
Conclusions:
- A significant improvement in survival was observed for infants born at 26-27 weeks gestational age.
- No significant increase in major neonatal morbidities was detected when comparing the two treatment periods, suggesting that enhanced survival was achieved without a corresponding rise in complications.
Introduction:
Survival has improved among very preterm born infants, but improved treatment strategies might be associated with increasing rates of neonatal morbidity. The aim of this study was to assess survival and major morbidities among very and extremely preterm born infants treated in a Danish neonatal intensive care unit.
Methods:
This was an observational cohort study including very preterm infants (gestational age (GA) < 32 weeks) born between year 2000 and 2013. Because of changes in three standard treatments from 2008, we aimed to compare survival and major neonatal morbidity between two birth-year periods: 2000-2007 and 2008-2013.
Results:
The overall survival rate increased from 81.6% to 85.0%. In GA group 26-27 weeks, survival increased from 65% to 89% (p = 0.02). A total of 31/412 (7.5%) in the first time period and 30/280 (10.7%) in the second time period were diagnosed with bronchopulmonary dysplasia. No difference was found for necrotising entrocolitis or intraventricular haemorhage. Antibiotic treatment was similar in the two time periods, though antibiotic treatment for suspected clinical infection increased in the second time period (35.1% versus 44.1%).
Conclusions:
We found a significant increase in the survival rate in GA group 26-27 weeks, but no significant increase in any major morbidity when comparing the two time periods.
Trial Registration:
not relevant.
Funding:
none.
