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Changes in In-Hospital Survival and Long-Term Neurodevelopmental Outcomes of Extremely Preterm Infants: A Retrospective Study of a Japanese Tertiary Center.
- Source :
-
The Journal of pediatrics [J Pediatr] 2023 Apr; Vol. 255, pp. 166-174.e4. Date of Electronic Publication: 2022 Dec 01. - Publication Year :
- 2023
-
Abstract
- Objectives: The objective of this study was to elucidate whether the survival and long-term neurodevelopmental outcomes of extremely preterm infants have improved in a Japanese tertiary center with an active treatment policy for infants born at 22-23 weeks of gestation.<br />Study Design: This single-centered retrospective cohort study enrolled extremely preterm infants treated at Saitama Medical Center, Saitama Medical University, from 2003 to 2014. Patients with major congenital abnormalities were excluded. Primary outcomes were in-hospital survival and severe neurodevelopmental impairment (NDI) at 6 years of age, which was defined as having severe cerebral palsy, severe cognitive impairment, severe visual impairment, or deafness. We assessed the changes in primary outcomes between the first (period 1; 2003-2008) and the second half (period 2; 2009-2014) of the study period and evaluated the association between birth-year and primary outcomes using multivariate logistic regression models.<br />Results: Of the 403 eligible patients, 340 (84%) survived to discharge. Among 248 patients available at 6 years of age, 43 (14%) were classified as having severe NDI. Between the 2 periods, in-hospital survival improved from 155 of 198 (78%) to 185 of 205 (90%), but severe NDI increased from 11 of 108 (10%) to 32 of 140 (23%). In multivariate logistic regression models adjusted for gestational age, birthweight, sex, singleton birth, and antenatal corticosteroids, the aOR (95% CI) of birth-year for in-hospital survival and severe NDI was 1.2 (1.1-1.3) and 1.1 (1.0-1.3), respectively.<br />Conclusion: Mortality among extremely preterm infants has improved over the past 12 years; nevertheless, no significant improvement was observed in the long-term neurodevelopmental outcomes.<br /> (Copyright © 2022 Elsevier Inc. All rights reserved.)
- Subjects :
- Child
Child, Preschool
Humans
Infant
Infant, Newborn
Pregnancy
Gestational Age
Hospital Mortality trends
Hospitals standards
Hospitals statistics & numerical data
Hospitals trends
Retrospective Studies
Tertiary Care Centers standards
Tertiary Care Centers statistics & numerical data
Tertiary Care Centers trends
Female
Japan epidemiology
Male
East Asian People
Infant, Extremely Premature
Neurodevelopmental Disorders epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6833
- Volume :
- 255
- Database :
- MEDLINE
- Journal :
- The Journal of pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 36462685
- Full Text :
- https://doi.org/10.1016/j.jpeds.2022.11.024