Incidence of and risk factors for neonatal morbidity after active perinatal care: extremely preterm infants study in Sweden (EXPRESS)

• Aims: The aim of this study was to determine the incidence of neonatal morbidity in extremely preterm infants and to identify associated risk factors. Methods: Population based study of infants born before 27 gestational weeks and admitted for neonatal intensive care in Sweden during 2004-2007. Results: Of 638 admitted infants, 141 died. Among these, life support was withdrawn in 55 infants because of anticipation of poor long-term outcome. Of 497 surviving infants, 10% developed severe intraventricular haemorrhage (IVH), 5.7% cystic periventricular leucomalacia (cPVL), 41% septicaemia and 5.8% necrotizing enterocolitis (NEC); 61% had patent ductus arteriosus (PDA) and 34% developed retinopathy of prematurity (ROP) stage >= 3. Eighty-five per cent needed mechanical ventilation and 25% developed severe bronchopulmonary dysplasia (BPD). Forty-seven per cent survived to one year of age without any severe IVH, cPVL, severe ROP, severe BPD or NEC. Tocolysis increased and prolonged mechanical ventilation decreased the chances of survival without these morbidities. Maternal smoking and higher gestational duration were associated with lower risk of severe ROP, whereas PDA and poor growth increased this risk. Conclusion: Half of the infants surviving extremely preterm birth suffered from severe neonatal morbidities. Studies on how to reduce these morbidities and on the long-term health of survivors are warranted.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Pediatrik (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Pediatrics (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  (hsv//swe)

MEDICAL AND HEALTH SCIENCES  (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Obstetrics, Gynecology and Reproductive Medicine (hsv//eng)

Nyckelord

MEDICIN

MEDICINE

enterocolitis

Patent ductus arteriosus

Necrotizing

Bronchopulmonary dysplasia

Intraventricular haemorrhage

Retinopathy of prematurity

Bronchopulmonary dysplasia; Intraventricular haemorrhage; Necrotizing enterocolitis; Patent ductus arteriosus; Retinopathy of prematurity

Necrotizing enterocolitis

Medicine

Medicin

Reproduktiv och perinatal omvårdnad

Reproductive and perinatal care

Female

Gestational Age

Hospital Mortality

Humans

Incidence

Infant Mortality

Infant

Newborn

Infant

Premature

Infant

Premature

Diseases

epidemiology

mortality

Intensive Care

Neonatal

Male

Morbidity

Outcome Assessment (Health Care)

Perinatal Care

Risk Factors

Sweden

epidemiology

Publikations- och innehållstyp

art (ämneskategori)

ref (ämneskategori)