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Changes Overtime in Perinatal Management and Outcomes of Extremely Preterm Infants in One Tertiary Care Romanian

Diana Ungureanu1, Nansi S Boghossian2, Laura Mihaela Suciu3

  • 1Neonatology Department, Maternity Hospital "Ioan Aurel Sbârcea", 500025 Brasov, Romania.

Medicina (Kaunas, Lithuania)
|August 26, 2022
PubMed

Insights

Extremely preterm infants born between 25-28 weeks showed improved survival rates in a Romanian tertiary care unit. While mortality and severe intraventricular hemorrhage decreased, necrotizing enterocolitis increased in the later study period.

Area of Science:

  • Neonatalogy
  • Perinatal Medicine
  • Pediatric Critical Care

Background:

  • Extremely preterm infants (25-28 weeks gestation) face high risks of mortality and major neonatal morbidities.
  • Romanian tertiary care unit data provides insight into trends for this vulnerable population.

Purpose of the Study:

  • To analyze changes in perinatal management, mortality, and major neonatal morbidities in extremely preterm infants over time.
  • To compare these trends with international data for extremely preterm infants.

Main Methods:

  • Study included infants born at 25-28 weeks gestation across two 4-year periods (2007-2010 and 2015-2018) at a Romanian tertiary neonatal academic center.
  • Major morbidities included severe intraventricular hemorrhage (IVH), severe retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC), and bronchopulmonary dysplasia (BPD).
  • Adjusted logistic regression models assessed the association between study period and mortality/morbidity outcomes.

Main Results:

  • The later cohort (2015-2018) showed significantly lower mortality (OR: 0.19) and severe IVH (OR: 0.26) compared to the earlier cohort (2007-2010).
  • An increased incidence of necrotizing enterocolitis (NEC) was observed in the later cohort (OR: 19.37).
  • Rates of bronchopulmonary dysplasia (BPD) and retinopathy of prematurity (ROP) did not differ significantly between the two periods.

Conclusions:

  • Perinatal management evolved with increased antenatal antibiotic use and cesarean deliveries, while antenatal steroid administration remained consistent.
  • Overall mortality significantly decreased in the later cohort, particularly for infants born at 25-26 weeks gestation.
  • While NEC rates rose, severe IVH, BPD, and ROP trends showed improvement or stability, indicating evolving care impacts for extremely preterm infants.

Keywords:
antenatal managementextremely preterm newbornsneonatal morbiditiesneonatal mortality

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