Survival and morbidity of preterm children born at 22 through 34 weeks' gestation in France in 2011: results of the EPIPAGE-2 cohort study.
Pierre-Yves Ancel,François Goffinet,Pierre Kuhn,Bruno Langer,Jacqueline Matis,Xavier Hernandorena,Pierre Chabanier,Laurence Joly-Pedespan,Bénédicte Lecomte,Françoise Vendittelli,Michel Dreyfus,Bernard Guillois,Antoine Burguet,Pierre Sagot,Jacques Sizun,Alain Beuchée,Florence Rouget,Amélie Favreau,Elie Saliba,Nathalie Bednarek,Patrice Morville,Gérard Thiriez,Loïc Marpeau,Stéphane Marret,Gilles Kayem,Xavier Durrmeyer,Michèle Granier,Olivier Baud,Pierre-Henri Jarreau,Delphine Mitanchez,Pascal Boileau,Pierre Boulot,Gilles Cambonie,Hubert Daudé,Antoine Bédu,Fabienne Mons,Jeanne Fresson,Rachel Vieux,Catherine Alberge,Catherine Arnaud,Christophe Vayssière,Patrick Truffert,Véronique Pierrat,Damien Subtil,Claude D'Ercole,Catherine Gire,Umberto Simeoni,André Bongain,Loïc Sentilhes,Jean-Christophe Rozé,Jean Gondry,André Leke,Michel Deiber,Olivier Claris,Jean-Charles Picaud,Anne Ego,Thierry Debillon,Anne Poulichet,Eliane Coliné,Anne Favre,Olivier Fléchelles,Sylvain Samperiz,Duksha Ramful,Bernard Branger,Valérie Benhammou,Laurence Foix-L’Hélias,Laetitia Marchand-Martin,Monique Kaminski +67 more
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A substantial improvement in survival in France for newborns born at 25 through 31 weeks' gestation was accompanied by an important reduction in severe morbidity, but survival remained rare before 25 weeks, and improvement at extremely low gestational age may be possible.Abstract:
Up-to-date estimates of the health outcomes of preterm children are needed for assessing perinatal care, informing parents, making decisions about care, and providing evidence for clinical guidelines. To determine survival and neonatal morbidity of infants born from 22 through 34 completed weeks' gestation in France in 2011 and compare these outcomes with a comparable cohort in 1997. The EPIPAGE-2 study is a national, prospective, population-based cohort study conducted in all maternity and neonatal units in France in 2011. A total of 2205 births (stillbirths and live births) and terminations of pregnancy at 22 through 26 weeks' gestation, 3257 at 27 through 31 weeks, and 1234 at 32 through 34 weeks were studied. Cohort data were collected from January 1 through December 31, 1997, and from March 28 through December 31, 2011. Analyses for 1997 were run for the entire year and then separately for April to December; the rates for survival and morbidities did not differ. Data are therefore presented for the whole year in 1997 and the 8-month and 6-month periods in 2011. Survival to discharge and survival without any of the following adverse outcomes: grade III or IV intraventricular hemorrhage, cystic periventricular leukomalacia, severe bronchopulmonary dysplasia, retinopathy of prematurity (stage 3 or higher), or necrotizing enterocolitis (stages 2-3). A total of 0.7% of infants born before 24 weeks' gestation survived to discharge: 31.2% of those born at 24 weeks, 59.1% at 25 weeks, and 75.3% at 26 weeks. Survival rates were 93.6% at 27 through 31 weeks and 98.9% at 32 through 34 weeks. Infants discharged home without severe neonatal morbidity represented 0% at 23 weeks, 11.6% at 24 weeks, 30.0% at 25 weeks, 47.5% at 26 weeks, 81.3% at 27 through 31 weeks, and 96.8% at 32 through 34 weeks. Compared with 1997, the proportion of infants surviving without severe morbidity in 2011 increased by 14.4% (P < .001) at 25 through 29 weeks and 6% (P < .001) at 30 through 31 weeks but did not change appreciably for those born at less than 25 weeks. The rates of antenatal corticosteroid use, induced preterm deliveries, cesarean deliveries, and surfactant use increased significantly in all gestational-age groups, except at 22 through 23 weeks. The substantial improvement in survival in France for newborns born at 25 through 31 weeks' gestation was accompanied by an important reduction in severe morbidity, but survival remained rare before 25 weeks. Although improvement in survival at extremely low gestational age may be possible, its effect on long-term outcomes requires further studies. The long-term results of the EPIPAGE-2 study will be informative in this regard.read more
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Trends in Care Practices, Morbidity, and Mortality of Extremely Preterm Neonates, 1993-2012.
Barbara J. Stoll,Nellie I. Hansen,Edward F. Bell,Michele C. Walsh,Waldemar A. Carlo,Seetha Shankaran,Abbot R. Laptook,Pablo J. Sánchez,Krisa P. Van Meurs,Krisa P. Van Meurs,Myra H. Wyckoff,Abhik Das,Ellen C. Hale,M. Bethany Ball,M. Bethany Ball,Nancy S. Newman,Kurt Schibler,Brenda B. Poindexter,Kathleen A. Kennedy,C. Michael Cotten,Kristi L. Watterberg,Carl T. D'Angio,Sara B. DeMauro,William E Truog,Uday Devaskar,Rosemary D. Higgins +25 more
TL;DR: Among extremely preterm infants born at US academic centers over the last 20 years, changes in maternal and infant care practices and modest reductions in several morbidities were observed, although bronchopulmonary dysplasia increased.
Journal ArticleDOI
Trends in Care Practices, Morbidity, and Mortality of Extremely Preterm Neonates, 1993-2012
Barbara J. Stoll,Nellie I. Hansen,Edward F. Bell,Michele C. Walsh,Waldemar A. Carlo,Seetha Shankaran,Abbot R. Laptook,Pablo J. Sánchez,Krisa P. Van Meurs,Krisa P. Van Meurs,Myra H. Wyckoff,Abhik Das,Ellen C. Hale,M. Bethany Ball,M. Bethany Ball,Nancy S. Newman,Kurt Schibler,Brenda B. Poindexter,Kathleen A. Kennedy,C. Michael Cotten,Kristi L. Watterberg,Carl T. D'Angio,Sara B. DeMauro,William E Truog,Uday Devaskar,Rosemary D. Higgins +25 more
TL;DR: There have been considerable changes in care for mothers in preterm labor and for extremely preterm infants since the 1990s, and the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network has monitored changes.
Journal ArticleDOI
Between-Hospital Variation in Treatment and Outcomes in Extremely Preterm Infants
Matthew A. Rysavy,Lei Li,Edward F. Bell,Abhik Das,Susan R. Hintz,Barbara J. Stoll,Betty R. Vohr,Waldemar A. Carlo,Seetha Shankaran,Michele C. Walsh,Jon E. Tyson,C. Michael Cotten,P. Brian Smith,Jeff Murray,Tarah T. Colaizy,Jane E. Brumbaugh,Rosemary D. Higgins +16 more
TL;DR: Differences in hospital practices regarding the initiation of active treatment in infants born at 22, 23, or 24 weeks of gestation explain some of the between-hospital variation in survival and survival without impairment among such patients.
Journal ArticleDOI
Cognitive outcomes of children born extremely or very preterm since the 1990s and associated risk factors: A meta-analysis and meta-regression
E. Sabrina Twilhaar,Rebecca M. Wade,Jorrit F. de Kieviet,Johannes B. van Goudoever,Johannes B. van Goudoever,Ruurd M. van Elburg,Jaap Oosterlaan,Jaap Oosterlaan +7 more
TL;DR: Bronchopulmonary dysplasia was found to be a crucial factor for cognitive outcome and lowering the high incidence of BPD may be key to improving long-term outcomes after EP/VP birth.
References
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National regional and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications.
Hannah Blencowe,Simon Cousens,Mikkel Z. Oestergaard,Doris Chou,Ann-Beth Moller,Rajesh Narwal,Alma J Adler,Claudia Vera Garcia,Sarah L Rohde,Lale Say,Joy E Lawn +10 more
TL;DR: Worldwide, regional, and national estimates of preterm birth rates for 184 countries in 2010 with time trends for selected countries are reported, and a quantitative assessment of the uncertainty surrounding these estimates is provided.
Journal ArticleDOI
Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging
Martin J. Bell,Jessie L. Ternberg,Ralph D. Feigin,James P. Keating,Richard Marshall,Leslie L. Barton,Thomas Brotherton +6 more
TL;DR: These studies support the use of combination antimicrobial therapy in the treatment of infants with NEC and suggest vigorous diagnostic and supportive measures are appropriate for Stage I infants.
Journal ArticleDOI
An overview of mortality and sequelae of preterm birth from infancy to adulthood.
TL;DR: Because mortality rates have fallen, the focus for perinatal interventions is to develop strategies to reduce long-term morbidity, especially the prevention of brain injury and abnormal brain development.
Journal ArticleDOI
Neonatal Outcomes of Extremely Preterm Infants From the NICHD Neonatal Research Network
Barbara J. Stoll,Nellie I. Hansen,Edward F. Bell,Seetha Shankaran,Abbot R. Laptook,Michele C. Walsh,Ellen C. Hale,Nancy S. Newman,Kurt Schibler,Waldemar A. Carlo,Kathleen A. Kennedy,Brenda B. Poindexter,Neil N. Finer,Richard A. Ehrenkranz,Shahnaz Duara,Pablo J. Sánchez,T. Michael O'Shea,Ronald N. Goldberg,Krisa P. Van Meurs,Roger G. Faix,Dale L. Phelps,Ivan D. Frantz,Kristi L. Watterberg,Shampa Saha,Abhik Das,Rosemary D. Higgins +25 more
TL;DR: Although the majority of infants with GAs of ≥24 weeks survive, high rates of morbidity among survivors continue to be observed.
Journal Article
The International Classification of Retinopathy of Prematurity Revisited : An International Committee for the Classification of Retinopathy of Prematurity
Glen A. Gole,Anna L. Ells,Ximena Katz,Gerd Holmström,Alistair R. Fielder,Antonio Capone,John T. Flynn,William G. Good,Jonathan M. Holmes,J. Arch McNamara,Earl A. Palmer,Graham E. Quinn,Michael J. Shapiro,Michael G. J. Trese,David K. Wallace +14 more
TL;DR: An international group of pediatric ophthalmologists and retinal specialists has developed a consensus document that revises some aspects of ICROP, including introduction of the concept of a more virulent form of retinopathy observed in the tiniest babies.
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