Birth outcomes between 22 and 26 weeks' gestation in national population-based cohorts from Sweden, England and France
(2022) In Acta Paediatrica, International Journal of Paediatrics 111(1). p.59-75- Abstract
Aim: We investigated the timing of survival differences and effects on morbidity for foetuses alive at maternal admission to hospital delivered at 22 to 26 weeks’ gestational age (GA). Methods: Data from the EXPRESS (Sweden, 2004–07), EPICure-2 (England, 2006) and EPIPAGE-2 (France, 2011) cohorts were harmonised. Survival, stratified by GA, was analysed to 112 days using Kaplan-Meier analyses and Cox regression adjusted for population and pregnancy characteristics; neonatal morbidities, survival to discharge and follow-up and outcomes at 2–3 years of age were compared. Results: Among 769 EXPRESS, 2310 EPICure-2 and 1359 EPIPAGE-2 foetuses, 112-day survival was, respectively, 28.2%, 10.8% and 0.5% at 22–23 weeks’ GA; 68.5%, 40.0% and... (More)
Aim: We investigated the timing of survival differences and effects on morbidity for foetuses alive at maternal admission to hospital delivered at 22 to 26 weeks’ gestational age (GA). Methods: Data from the EXPRESS (Sweden, 2004–07), EPICure-2 (England, 2006) and EPIPAGE-2 (France, 2011) cohorts were harmonised. Survival, stratified by GA, was analysed to 112 days using Kaplan-Meier analyses and Cox regression adjusted for population and pregnancy characteristics; neonatal morbidities, survival to discharge and follow-up and outcomes at 2–3 years of age were compared. Results: Among 769 EXPRESS, 2310 EPICure-2 and 1359 EPIPAGE-2 foetuses, 112-day survival was, respectively, 28.2%, 10.8% and 0.5% at 22–23 weeks’ GA; 68.5%, 40.0% and 23.6% at 24 weeks; 80.5%, 64.8% and 56.9% at 25 weeks; and 86.6%, 77.1% and 74.4% at 26 weeks. Deaths were most marked in EPIPAGE-2 before 1 day at 22–23 and 24 weeks GA. At 25 weeks, survival varied before 28 days; differences at 26 weeks were minimal. Cox analyses were consistent with the Kaplan-Meier analyses. Variations in morbidities were not clearly associated with survival. Conclusion: Differences in survival and morbidity outcomes for extremely preterm births are evident despite adjustment for background characteristics. No clear relationship was identified between early mortality and later patterns of morbidity.
(Less)
- author
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- epidemiology, extreme preterm birth, international comparisons, neonatal, perinatal, survival analysis
- in
- Acta Paediatrica, International Journal of Paediatrics
- volume
- 111
- issue
- 1
- pages
- 59 - 75
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:34469604
- scopus:85114725542
- ISSN
- 0803-5253
- DOI
- 10.1111/apa.16084
- language
- English
- LU publication?
- yes
- additional info
- Publisher Copyright: © 2021 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.
- id
- f87fb7d2-45c8-4299-a2b8-6fee62c39945
- date added to LUP
- 2021-10-12 15:28:46
- date last changed
- 2024-11-03 08:28:37
@article{f87fb7d2-45c8-4299-a2b8-6fee62c39945,
abstract = {{<p>Aim: We investigated the timing of survival differences and effects on morbidity for foetuses alive at maternal admission to hospital delivered at 22 to 26 weeks’ gestational age (GA). Methods: Data from the EXPRESS (Sweden, 2004–07), EPICure-2 (England, 2006) and EPIPAGE-2 (France, 2011) cohorts were harmonised. Survival, stratified by GA, was analysed to 112 days using Kaplan-Meier analyses and Cox regression adjusted for population and pregnancy characteristics; neonatal morbidities, survival to discharge and follow-up and outcomes at 2–3 years of age were compared. Results: Among 769 EXPRESS, 2310 EPICure-2 and 1359 EPIPAGE-2 foetuses, 112-day survival was, respectively, 28.2%, 10.8% and 0.5% at 22–23 weeks’ GA; 68.5%, 40.0% and 23.6% at 24 weeks; 80.5%, 64.8% and 56.9% at 25 weeks; and 86.6%, 77.1% and 74.4% at 26 weeks. Deaths were most marked in EPIPAGE-2 before 1 day at 22–23 and 24 weeks GA. At 25 weeks, survival varied before 28 days; differences at 26 weeks were minimal. Cox analyses were consistent with the Kaplan-Meier analyses. Variations in morbidities were not clearly associated with survival. Conclusion: Differences in survival and morbidity outcomes for extremely preterm births are evident despite adjustment for background characteristics. No clear relationship was identified between early mortality and later patterns of morbidity.</p>}},
author = {{Morgan, Andrei S. and Zeitlin, Jennifer and Källén, Karin and Draper, Elizabeth S. and Marsal, Karel and Norman, Mikael and Serenius, Fredrik and van Buuren, Stef and Johnson, Samantha and Benhammou, Valérie and Pierrat, Véronique and Kaminski, Monique and Foix L'Helias, Laurence and Ancel, Pierre Yves and Marlow, Neil}},
issn = {{0803-5253}},
keywords = {{epidemiology; extreme preterm birth; international comparisons; neonatal; perinatal; survival analysis}},
language = {{eng}},
number = {{1}},
pages = {{59--75}},
publisher = {{Wiley-Blackwell}},
series = {{Acta Paediatrica, International Journal of Paediatrics}},
title = {{Birth outcomes between 22 and 26 weeks' gestation in national population-based cohorts from Sweden, England and France}},
url = {{http://dx.doi.org/10.1111/apa.16084}},
doi = {{10.1111/apa.16084}},
volume = {{111}},
year = {{2022}},
}