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.
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http://dx.doi.org/10.1016/j.earlhumdev.2022.105618 | DOI Listing |
Cureus
December 2024
Pediatrics, Carol Davila University of Medicine and Pharmacy, Bucharest, ROU.
Extreme prematurity involves a series of complications that a multidisciplinary team should manage. Taking into account the risks related to premature newborns, such as maternal-fetal infections, intrauterine growth restriction, and certain comorbidities associated with young gestational age, our objective is to highlight the importance of a multidisciplinary team in approaching cases with an unfavorable prognosis. This is a case report of an extremely preterm newborn who came from a high-risk pregnancy and needed long-term hospitalization in the Neonatal Intensive Care Unit (NICU) and mechanical ventilation.
View Article and Find Full Text PDFCureus
December 2024
Pharmacology, Ministry of National Guard, AlAhsa, SAU.
Introduction Neonatal sepsis is defined as a systemic illness caused by bacteria, viruses, or fungi, characterized by hemodynamic abnormalities and clinical findings that result in morbidity and mortality. Neonatal morbidity and mortality are significantly influenced by neonatal sepsis. Causative pathogens and antimicrobial sensitivity profiles have changed over time, with significant geographic variation.
View Article and Find Full Text PDFOpen Respir Med J
November 2024
Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdul Aziz University for Health Sciences, Riyadh, Saudi Arabia.
Background: Extremely preterm infants (EPIs) often require advanced respiratory support to survive, and one such intervention is the heated, humidified, high-flow nasal cannula (HHHFNC). While the use of this cannula in EPIs has been studied, the relationship between its use and the length of hospital stay is an important yet unexplored research area that we aim to investigate in this study.
Methods: In a quantitative retrospective cohort study, data were extracted from an electronic database.
Nephrol Dial Transplant
January 2025
Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan.
Background And Hypothesis: It is unclear if low birth weight (LBW), preterm birth and small for gestational age (SGA) could synergistically cause chronic kidney disease (CKD) and end-stage kidney disease (ESKD). This cohort study was conducted to examine their individual and combined impacts on the development of CKD and ESKD in childhood.
Methods: From the Taiwan Maternal and Child Health Database, we identified 1 477 128 newborns born between January 1, 2009, and December 31, 2016.
Introduction: A recent scoping review identified histological chorioamnionitis (HCA), small for gestational age (SGA), and bubbly/cystic appearance on chest X-ray (bubbly/cystic CXR) as risk factors for severe bronchopulmonary dysplasia (BPD). To further validate these results, a large-scale database was analyzed.
Methods: This retrospective multicenter cohort study included infants born at <28 weeks' gestational age between 2003 and 2016.
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