TY - JOUR
T1 - Mortality after 36 weeks postmenstrual age of extremely preterm infants in neonatal care
T2 - The impact of growth impairment and bronchopulmonary dysplasia
AU - Dassios, Theodore
AU - Williams, Emma
AU - Hickey, Ann
AU - Bhat, Ravindra
AU - Greenough, Anne
N1 - Funding Information:
Emma Williams was supported by a grant from the Charles Wolfson Charitable Trust and a non-conditional educational grant from SLE. This research was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust and King's College London. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
Publisher Copyright:
© 2022 Elsevier B.V.
PY - 2022/8
Y1 - 2022/8
N2 - Background: A small group of extremely preterm infants survive to 36 weeks postmenstrual age (PMA), but die before discharge from neonatal care. Aims: To investigate which epidemiological and clinical parameters were related to death after 36 weeks PMA in extremely preterm infants. Study design: Retrospective whole-population study. Subjects: All infants born <28 weeks of gestation admitted to a neonatal unit in England between 2014 and 2018. Outcome measures: Mortality after 36 weeks PMA and before discharge from neonatal care. Bronchopulmonary dysplasia (BPD) defined as any respiratory support at 36 weeks PMA. Results: Death after 36 weeks PMA occurred in 156 of a total of 11.747 included infants (1.3 %) and at a median (IQR) age of 130 (93–164) days. A lower gestational age [Odds Ratio: 0.82, 95 % CI:0.72–0.94, adjusted p = 0.005], lower birth weight z-score [Odds Ratio: 0.45, 95 % CI:0.36–0.56, adjusted p < 0.001], greater absolute difference in weight z-score from birth to 36 weeks PMA [Odds Ratio: 0.46, 95 % CI:0.38–0.56, adjusted p < 0.001] were independently associated with death after 36 weeks PMA. A diagnosis of BPD [Odds Ratio: 4.57, 95 % CI:2.19–9.54, adjusted p < 0.001] and of necrotising enterocolitis requiring surgery [Odds Ratio: 2.81, 95 % CI:1.82–4.34, adjusted p < 0.001] were also independently associated with death after 36 weeks PMA. Conclusions: Mortality of extremely preterm infants after 36 weeks postmenstrual age is associated with lower gestational age and more impaired growth. The diagnoses of bronchopulmonary dysplasia and necrotising enterocolitis were associated with a higher risk of death after 36 weeks postmenstrual age and before discharge from neonatal care.
AB - Background: A small group of extremely preterm infants survive to 36 weeks postmenstrual age (PMA), but die before discharge from neonatal care. Aims: To investigate which epidemiological and clinical parameters were related to death after 36 weeks PMA in extremely preterm infants. Study design: Retrospective whole-population study. Subjects: All infants born <28 weeks of gestation admitted to a neonatal unit in England between 2014 and 2018. Outcome measures: Mortality after 36 weeks PMA and before discharge from neonatal care. Bronchopulmonary dysplasia (BPD) defined as any respiratory support at 36 weeks PMA. Results: Death after 36 weeks PMA occurred in 156 of a total of 11.747 included infants (1.3 %) and at a median (IQR) age of 130 (93–164) days. A lower gestational age [Odds Ratio: 0.82, 95 % CI:0.72–0.94, adjusted p = 0.005], lower birth weight z-score [Odds Ratio: 0.45, 95 % CI:0.36–0.56, adjusted p < 0.001], greater absolute difference in weight z-score from birth to 36 weeks PMA [Odds Ratio: 0.46, 95 % CI:0.38–0.56, adjusted p < 0.001] were independently associated with death after 36 weeks PMA. A diagnosis of BPD [Odds Ratio: 4.57, 95 % CI:2.19–9.54, adjusted p < 0.001] and of necrotising enterocolitis requiring surgery [Odds Ratio: 2.81, 95 % CI:1.82–4.34, adjusted p < 0.001] were also independently associated with death after 36 weeks PMA. Conclusions: Mortality of extremely preterm infants after 36 weeks postmenstrual age is associated with lower gestational age and more impaired growth. The diagnoses of bronchopulmonary dysplasia and necrotising enterocolitis were associated with a higher risk of death after 36 weeks postmenstrual age and before discharge from neonatal care.
KW - Bronchopulmonary dysplasia
KW - Growth
KW - Necrotising enterocolitis
KW - Neonatal mortality
UR - http://www.scopus.com/inward/record.url?scp=85132886557&partnerID=8YFLogxK
U2 - 10.1016/j.earlhumdev.2022.105618
DO - 10.1016/j.earlhumdev.2022.105618
M3 - Article
AN - SCOPUS:85132886557
SN - 0378-3782
VL - 171
JO - Early Human Development
JF - Early Human Development
M1 - 105618
ER -
