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Circumstances, causes and timing of death in extremely preterm infants admitted to NICU: The EPIPAGE-2 study
Pascal Boileau1, Mathilde Letouzey1,2, Andrei S Morgan2,3,4
1Department of Neonatal Pediatrics, Poissy Saint Germain Hospital, Versailles Saint Quentin en Yvelines University, Poissy, France.
Aim:
To describe the circumstances, causes and timing of death in extremely preterm infants.
Methods:
We included from the EPIPAGE-2 study infants born at 24-26 weeks in 2011 admitted to neonatal intensive care units (NICU). Vital status and circumstances of death were used to define three groups of infants: alive at discharge, death with or without withholding or withdrawing life-sustaining treatment (WWLST). The main cause of death was classified as respiratory disease, necrotizing enterocolitis, infection, central nervous system (CNS) injury, other or unknown.
Results:
Among 768 infants admitted to NICU, 224 died among which 89 died without WWLST and 135 with WWLST. The main causes of death were respiratory disease (38%), CNS injury (30%) and infection (12%). Among the infants who died with WWLST, CNS injury was the main cause of death (47%), whereas respiratory disease (56%) and infection (20%) were the main causes in case of death without WWLST. Half (51%) of all deaths occurred within the first 7 days of life, and 35% occurred within 8 and 28 days.
Conclusion:
The death of extremely preterm infants in NICU is a complex phenomenon in which the circumstances and causes of death are intertwined.
