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Mortality and morbidity in very preterm infants in Switzerland spanning 16 years (2006-2021)

Anaïs Mons1, Otis Olela2, Nicolas Silvestrini3

  • 1Division of Neonatology and Paediatric Intensive Care, Paediatrics, Gynaecology and Obstetrics, Department of Women, Child and Adolescent Medicine, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland anaischloe.mons@hug.ch.

BMJ Paediatrics Open
|July 28, 2026
PubMed

Insights

Survival rates for very preterm infants in Switzerland significantly improved from 2006-2021, particularly for those born before 26 weeks gestational age. However, survival without major complications remained stable, with increased rates of bronchopulmonary dysplasia and retinopathy of prematurity in survivors.

Area of Science:

  • Neonatalogy
  • Perinatal Epidemiology
  • Public Health

Background:

  • Very preterm infants (<32 weeks gestational age) face significant mortality and morbidity risks.
  • Monitoring survival and complication rates is crucial for assessing neonatal care quality.
  • Longitudinal data is needed to understand trends in very preterm infant outcomes.

Purpose of the Study:

  • To analyze population-based trends in gestational age-stratified mortality and morbidity for very preterm infants in Switzerland over 16 years.
  • To evaluate changes in survival rates and the incidence of major complications.
  • To identify specific gestational age groups with the most significant outcome improvements or challenges.

Main Methods:

  • A Swiss population-based study utilizing prospectively collected data.
  • Inclusion of live-born infants with gestational age <32 weeks from 2006 to 2021, divided into three periods (2006-2011, 2012-2016, 2017-2021).
  • Data sourced from the Swiss Neonatal Network covering all Level III neonatal intensive care units.

Main Results:

  • Overall survival increased significantly from 85.4% to 89.7% (p<0.01), with the most substantial gains in infants born before 26 weeks gestational age.
  • Delivery room and NICU mortality rates significantly declined.
  • Survival without major complications (e.g., bronchopulmonary dysplasia, intraventricular hemorrhage, necrotizing enterocolitis, retinopathy of prematurity, cystic periventricular leukomalacia) remained stable at approximately 72% among survivors.
  • Incidence of bronchopulmonary dysplasia and retinopathy of prematurity increased, while necrotizing enterocolitis rose only in 25-week infants, and cystic periventricular leukomalacia declined.

Conclusions:

  • Survival rates for very preterm infants in Switzerland have improved between 2006 and 2021, especially for the extremely preterm (<26 weeks gestational age).
  • Survival without major comorbidities for infants born between 23-31 weeks gestational age remained unchanged.
  • While overall survival improved, specific morbidities like bronchopulmonary dysplasia and retinopathy of prematurity increased in survivors, highlighting the need for continued research and improved management strategies.
Abstract

Keywords:
EpidemiologyMortalityNeonatology

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