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

Austeng, Dordi; Blennow, Mats; Ewald, Uwe; Fellman, Vineta LU ; Fritz, Thomas; Hellstrom-Westas, Lena; Hellstrom, Ann; Holmgren, Per Ake; Holmstrom, Gerd and Jakobsson, Peter, et al. (2010) In Acta Pædiatrica 99(7). p.978-992
Abstract
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 Among these, life support was withdrawn in 55 infants because of anticipation of poor long-term outcome.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.... (More)
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 Among these, life support was withdrawn in 55 infants because of anticipation of poor long-term outcome.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. (Less)
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publication status
published
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keywords
Patent ductus arteriosus, enterocolitis, Necrotizing, Bronchopulmonary dysplasia, Intraventricular haemorrhage, Retinopathy of prematurity
in
Acta Pædiatrica
volume
99
issue
7
pages
978 - 992
publisher
Wiley-Blackwell Publishing Ltd
external identifiers
  • wos:000278294800008
  • scopus:77953201457
ISSN
1651-2227
DOI
10.1111/j.1651-2227.2010.01846.x
language
English
LU publication?
yes
id
86cee949-d5fe-4ce0-8597-205747375a98 (old id 1632522)
date added to LUP
2010-07-21 14:49:11
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2018-05-29 12:03:16
@article{86cee949-d5fe-4ce0-8597-205747375a98,
  abstract     = {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.},
  author       = {Austeng, Dordi and Blennow, Mats and Ewald, Uwe and Fellman, Vineta and Fritz, Thomas and Hellstrom-Westas, Lena and Hellstrom, Ann and Holmgren, Per Ake and Holmstrom, Gerd and Jakobsson, Peter and Jeppsson, Annika and Johansson, Kent and Källén, Karin and Lagercrantz, Hugo and Laurini, Ricardo and Lindberg, Eva and Lundqvist, Anita and Marsal, Karel and Nilstun, Tore and Norden-Lindeberg, Solveig and Norman, Mikael and Olhager, Elisabeth and Oestlund, Ingrid and Serenius, Fredrik and Simic, Marija and Sjors, Gunnar and Stigson, Lennart and Stjernqvist, Karin and Stromberg, Bo and Tornqvist, Kristina and Wennergren, Margareta and Wallin, Agneta and Westgren, Magnus},
  issn         = {1651-2227},
  keyword      = {Patent ductus arteriosus,enterocolitis,Necrotizing,Bronchopulmonary dysplasia,Intraventricular haemorrhage,Retinopathy of prematurity},
  language     = {eng},
  number       = {7},
  pages        = {978--992},
  publisher    = {Wiley-Blackwell Publishing Ltd},
  series       = {Acta Pædiatrica},
  title        = {Incidence of and risk factors for neonatal morbidity after active perinatal care: extremely preterm infants study in Sweden (EXPRESS)},
  url          = {http://dx.doi.org/10.1111/j.1651-2227.2010.01846.x},
  volume       = {99},
  year         = {2010},
}