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
TLDR
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.Abstract:
Importance Extremely preterm infants contribute disproportionately to neonatal morbidity and mortality. Objective To review 20-year trends in maternal/neonatal care, complications, and mortality among extremely preterm infants born at Neonatal Research Network centers. Design, Setting, Participants Prospective registry of 34 636 infants, 22 to 28 weeks’ gestation, birth weight of 401 to 1500 g, and born at 26 network centers between 1993 and 2012. Exposures Extremely preterm birth. Main Outcomes and Measures Maternal/neonatal care, morbidities, and survival. Major morbidities, reported for infants who survived more than 12 hours, were severe necrotizing enterocolitis, infection, bronchopulmonary dysplasia, severe intracranial hemorrhage, cystic periventricular leukomalacia, and/or severe retinopathy of prematurity. Regression models assessed yearly changes and were adjusted for study center, race/ethnicity, gestational age, birth weight for gestational age, and sex. Results Use of antenatal corticosteroids increased from 1993 to 2012 (24% [348 of 1431 infants]) to 87% (1674 of 1919 infants];P Conclusions and Relevance 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. Survival increased most markedly for infants born at 23 and 24 weeks’ gestation and survival without major morbidity increased for infants aged 25 to 28 weeks. These findings may be valuable in counseling families and developing novel interventions. Trial Registration clinicaltrials.gov Identifier:NCT00063063.read more
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European Consensus Guidelines on the Management of Respiratory Distress Syndrome - 2019 Update.
David G. Sweet,Virgilio P. Carnielli,Gorm Greisen,Mikko Hallman,Eren Özek,Arjan B. te Pas,Richard Plavka,Charles Christoph Roehr,Ola Didrik Saugstad,Umberto Simeoni,Christian P. Speer,Máximo Vento,Gerard H. A. Visser,Henry L. Halliday +13 more
TL;DR: The fourth update of “European Guidelines for the Management of RDS” by a European panel of experienced neonatologists and an expert perinatal obstetrician based on available literature up to the end of 2018 is reported.
Journal ArticleDOI
Bronchopulmonary Dysplasia: Executive Summary of a Workshop.
Rosemary D. Higgins,Alan H. Jobe,Marion Koso-Thomas,Eduardo Bancalari,Rose M. Viscardi,Tina V. Hartert,Rita M. Ryan,Suhas G. Kallapur,Robin H. Steinhorn,Girija G. Konduri,Stephanie D. Davis,Bernard Thébaud,Ronald I. Clyman,Joseph M. Collaco,Camilia R. Martin,Jason C. Woods,Neil N. Finer,Tonse N.K. Raju +17 more
TL;DR: A workshop on bronchopulmonary dysplasia held in October 2016 developed a proposal for an updated definition for BPD based on prior definitions and current care practices and discussed a research agenda and the strengths and limitations of available management options.
Journal ArticleDOI
The Diagnosis of Bronchopulmonary Dysplasia in Very Preterm Infants. An Evidence-based Approach.
Erik A. Jensen,Kevin Dysart,Marie G. Gantz,Scott A. McDonald,Nicolas A. Bamat,Martin Keszler,Haresh Kirpalani,Matthew M. Laughon,Brenda B. Poindexter,Andrea F. Duncan,Bradley A. Yoder,Eric C. Eichenwald,Sara B. DeMauro +12 more
TL;DR: The definition of bronchopulmonary dysplasia that best predicted early childhood morbidity categorized disease severity according to the mode of respiratory support administered at 36 weeks’ postmenstrual age, regardless of supplemental oxygen use.
Journal ArticleDOI
Necrotizing enterocolitis: new insights into pathogenesis and mechanisms.
TL;DR: The current approach to the diagnosis and treatment of NEC is examined, an overview of the current knowledge regarding its molecular underpinnings is provided and advances made within the past decade towards the development of specific preventive and treatment strategies for this devastating disease are highlighted.
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Neonatal necrotizing enterocolitis. Therapeutic decisions based upon clinical staging
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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.
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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.
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