Статья

Neonatal Outcomes of Extremely Preterm Infants From the NICHD Neonatal Research Network

Barbara J. StollDepartment of Pediatrics, School of Medicine, Emory University, Children's Healthcare of Atlanta, Atlanta, Georgia;Nellie I. HansenStatistics and Epidemiology Unit, RTI International, Research Triangle Park, North Carolina;Edward F. BellDepartment of Pediatrics, Carver College of Medicine, University of Iowa, Iowa City, Iowa;Seetha ShankaranDepartment of Pediatrics, School of Medicine, Wayne State University, Detroit, Michigan;Abbot R. LaptookDepartment of Pediatrics, Women and Infants' Hospital, Brown University, Providence, Rhode Island;Michele C. WalshDepartment of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio;Ellen C. HaleDepartment of Pediatrics, School of Medicine, Emory University, Children's Healthcare of Atlanta, Atlanta, Georgia;Nancy S. NewmanDepartment of Pediatrics, Rainbow Babies and Children's Hospital, Case Western Reserve University, Cleveland, Ohio;Kurt SchiblerDepartment of Pediatrics, School of Medicine, University of Cincinnati, Cincinnati, Ohio;Waldemar A. CarloDivision of Neonatology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama;Kathleen A. KennedyBrenda B. PoindexterDepartment of Pediatrics, School of Medicine, Indiana University, Indianapolis, Indiana;Neil N. FinerDepartment of Neonatology, University of California, San Diego, Medical Center, San Diego, California;Richard A. EhrenkranzDepartment of Pediatrics, School of Medicine, Yale University, New Haven, Connecticut;Shahnaz DuaraDepartment of Pediatrics, Miller School of Medicine, University of Miami, Miami, Florida;Pablo J. SánchezDepartment of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas;T. Michael O’SheaDepartment of Pediatrics, School of Medicine, Wake Forest University, Winston-Salem, North Carolina;Ronald N. GoldbergDepartment of Pediatrics, School of Medicine, Duke University, Durham, North Carolina;Krisa P. Van MeursDepartment of Pediatrics, School of Medicine, Stanford University Palo Alto, California;Roger G. FaixDivision of Neonatology, Department of Pediatrics, School of Medicine, University of Utah, Salt Lake City, Utah;Dale L. PhelpsDepartment of Pediatrics, School of Medicine and Dentistry, University of Rochester, Rochester, New York;Ivan D. FrantzDivision of Newborn Medicine, Department of Pediatrics, Floating Hospital for Children, Tufts Medical Center, Boston, Massachusetts;Kristi L. WatterbergDepartment of Pediatrics, University of New Mexico Health Sciences Center, Albuquerque, New Mexico;Shampa SahaStatistics and Epidemiology Unit, RTI International, Research Triangle Park, North Carolina;Abhik DasStatistics and Epidemiology Unit, RTI International, Rockville, Maryland; andRosemary D. HigginsEunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health Bethesda, Maryland

2010en

ABI

Аннотация

OBJECTIVE: This report presents data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network on care of and morbidity and mortality rates for very low birth weight infants, according to gestational age (GA). METHODS: Perinatal/neonatal data were collected for 9575 infants of extremely low GA (22-28 weeks) and very low birth weight (401-1500 g) who were born at network centers between January 1, 2003, and December 31, 2007. RESULTS: Rates of survival to discharge increased with increasing GA (6% at 22 weeks and 92% at 28 weeks); 1060 infants died at <or=12 hours, with most early deaths occurring at 22 and 23 weeks (85% and 43%, respectively). Rates of prenatal steroid use (13% and 53%, respectively), cesarean section (7% and 24%, respectively), and delivery room intubation (19% and 68%, respectively) increased markedly between 22 and 23 weeks. Infants at the lowest GAs were at greatest risk for morbidities. Overall, 93% had respiratory distress syndrome, 46% patent ductus arteriosus, 16% severe intraventricular hemorrhage, 11% necrotizing enterocolitis, and 36% late-onset sepsis. The new severity-based definition of bronchopulmonary dysplasia classified more infants as having bronchopulmonary dysplasia than did the traditional definition of supplemental oxygen use at 36 weeks (68%, compared with 42%). More than one-half of infants with extremely low GAs had undetermined retinopathy status at the time of discharge. Center differences in management and outcomes were identified. CONCLUSION: Although the majority of infants with GAs of >or=24 weeks survive, high rates of morbidity among survivors continue to be observed.

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Идентификаторы

DOI: 10.1542/peds.2009-2959

Цитирования и источники

Цитирований: 2Использованных источников: 0

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