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A birth population-based survey of preterm morbidity and mortality by gestational age

Xiaojing Guo1, Xiaoqiong Li2, Tingting Qi2

  • 1The NCH Key Laboratory of Neonatal Diseases, National Children's Medical Center, Children's Hospital of Fudan University, Shanghai, 201102, China.

BMC Pregnancy and Childbirth
|April 11, 2021
PubMed

Insights

Preterm birth rates in China are 4.47%, with higher mortality in extremely preterm infants. Leading centers show improved outcomes, highlighting the need for regional networks to prevent preterm birth.

Area of Science:

  • Neonatalogy
  • Perinatal Medicine
  • Public Health

Background:

  • Limited data exists on preterm birth prevalence and outcomes in China, despite millions of annual births.
  • This study characterized preterm birth outcomes by gestational age (GA) in Huai'an, China.

Purpose of the Study:

  • To determine the prevalence and outcomes of preterm births and hospitalized preterm infants based on gestational age.
  • To compare outcomes between different hospital categories and gestational age spectra.
  • To analyze risk factors for mortality in preterm births and hospitalized infants.

Main Methods:

  • Retrospective analysis of clinical data from 59,245 births in Huai'an (2018-2020).
  • Extracted data on 2651 preterm births and 1941 hospitalized preterm neonates from regional hospitals.
  • Utilized multivariable Poisson regression to analyze death risks.

Main Results:

  • Overall preterm birth prevalence was 4.47%, with GA-specific mortality rates ranging from 4.3% to 44.4%.
  • The leading referral hospital (HWCH) had a lower in-hospital death rate (4.1%) compared to other hospitals (10.3%).
  • Risk factors for mortality included low birth weight (<1000g), GA < 32 weeks, and birth defects; antenatal glucocorticoids and surfactant use decreased risks.

Conclusions:

  • Integrated data reveals preterm birth prevalence and GA-specific morbidity/mortality, showcasing the effectiveness of referral centers and regional networks.
  • The findings underscore the importance of a coordinated perinatal-neonatal network for improving preterm birth outcomes in China.
  • Further studies are recommended to validate protocols for preterm birth prevention.
Abstract

Keywords:
Birth populationGestationMorbidityMortalityPretermPrevalenceRegional perinatal-neonatal network

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