MAJOR MORBIDITY AND SURVIVAL OF EXTREMELY PRETERM INFANTS IN TERTIARY HOSPITAL

GA QAZI; I MAQSOOD; F ANWAAR

doi:10.54112/bcsrj.v2023i1.243

Authors

GA QAZI Department of Pediatrics, Children Hospital and Institute of Child Health ( CH&ICH) Multan, Pakistan
I MAQSOOD Department of Specialized Healthcare & Medical Education (SHC&ME), Children Hospital and Institute of Child Health ( CH&ICH) Multan, Pakistan
F ANWAAR Department of Peadiatrics, Nishter Medical University, and Hospital (NMU & H) Multan, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2023i1.243

Keywords:

survival, mortality, neonatal morbidity, Extremely preterm infants

Abstract

The retrospective study was conducted in the Peadiatrics Department of Nishter Medical Hospital & CH & ICH Multan from January 2010 to January 2020 to evaluate major morbidity and survival rate in extremely preterm infants. A total of 9095 infants were included in the study. The study participants were divided into 2 groups. Group I included infants who survived for less than 1 day, and Group II included infants who survived for more than 1 day. Detailed information regarding infant and maternal characteristics, birth certificates, prenatal care, antenatal conditions, death records, and all maternal and infant record from a year before to a year after birth was derived from the database of the hospital. Results show that infants born at 22-24 weeks had neonatal morbidities, including retinopathy of prematurity, sepsis, bronchopulmonary dysplasia, necrotizing enterocolitis, periventricular leukomalacia or grade III or IV IVH (Table I). 9% (818 infants) of survivors had grade III or IV intraventricular hemorrhage, and 3% (273 infants) had PVL, infants born at 22^nd to 23^rd weeks were at higher risk of developing these complications. Almost 80% of infants born at 22-25 weeks gestation suffered from at least one major morbidity. The 1-year survival rate of infants born at 22, 23, and 24 weeks was 5.9%, 27%, and 59.9%, respectively. It is concluded that less than half of the infants born at the lowest gestational ages (22 and 23 weeks) survive after resuscitation, and two-thirds have more than 1 major morbidity.

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References

Aubert, A. M., Costa, R., Johnson, S., Ådén, U., Cuttini, M., Koopman-Esseboom, C., Lebeer, J., Varendi, H., Zemlin, M., and Pierrat, V. (2023). Risk factors for cerebral palsy and movement difficulties in 5-year-old children born extremely preterm. Pediatric Research, 1-10.

Bell, E. F., Hintz, S. R., Hansen, N. I., Bann, C. M., Wyckoff, M. H., DeMauro, S. B., Walsh, M. C., Vohr, B. R., Stoll, B. J., and Carlo, W. A. (2022). Mortality, in-hospital morbidity, care practices, and 2-year outcomes for extremely preterm infants in the US, 2013-2018. Jama 327, 248-263.

Crilly, C. J., Haneuse, S., and Litt, J. S. (2021). Predicting the outcomes of preterm neonates beyond the neonatal intensive care unit: what are we missing? Pediatric research 89, 426-445.

Hashmi, J. A., Javaid, A., Qureshi, W. A., Naqvi, A. S. A. H., and Hashmi, M. O. J. (2021). Survival rate of premature babies admitted at a tertiary care hospital of Bahawalpur, Pakistan. Rawal Medical Journal 46, 854-854.

Janevic, T., Zeitlin, J., Egorova, N. N., Hebert, P., Balbierz, A., Stroustrup, A. M., and Howell, E. A. (2021). Racial and economic neighborhood segregation, site of delivery, and morbidity and mortality in neonates born very preterm. The Journal of Pediatrics 235, 116-123.

Kim, S. W., Andronis, L., Seppänen, A.-V., Aubert, A. M., Barros, H., Draper, E. S., Sentenac, M., Zeitlin, J., and Petrou, S. (2023). Health-related quality of life of children born very preterm: a multinational European cohort study. Quality of Life Research 32, 47-58.

Kono, Y., and Japan, N. R. N. o. (2021). Neurodevelopmental outcomes of very low birth weight infants in the Neonatal Research Network of Japan: importance of neonatal intensive care unit graduate follow-up. Clinical and experimental pediatrics 64, 313.

Lee, S. K., Beltempo, M., McMillan, D. D., Seshia, M., Singhal, N., Dow, K., Aziz, K., Piedboeuf, B., and Shah, P. S. (2020). Outcomes and care practices for preterm infants born at less than 33 weeks’ gestation: a quality-improvement study. Cmaj 192, E81-E91.

Mehra, R., Keene, D. E., Kershaw, T. S., Ickovics, J. R., and Warren, J. L. (2019). Racial and ethnic disparities in adverse birth outcomes: differences by racial residential segregation. SSM-population health 8, 100417.

Myrhaug, H. T., Brurberg, K. G., Hov, L., and Markestad, T. (2019). Survival and impairment of extremely premature infants: a meta-analysis. Pediatrics 143.

Nørgaard, S. K., Vissing, N. H., Chawes, B. L., Stokholm, J., Bønnelykke, K., and Bisgaard, H. (2021). Cost of illness in young children: A Prospective Birth Cohort Study. Children 8, 173.

Norman, M., Hallberg, B., Abrahamsson, T., Björklund, L. J., Domellöf, M., Farooqi, A., Bruun, C. F., Gadsbøll, C., Hellström-Westas, L., and Ingemansson, F. (2019). Association between year of birth and 1-year survival among extremely preterm infants in Sweden during 2004-2007 and 2014-2016. Jama 321, 1188-1199.

O’Reilly, H., Johnson, S., Ni, Y., Wolke, D., and Marlow, N. (2020). Neuropsychological outcomes at 19 years of age following extremely preterm birth. Pediatrics 145.

Ramachandran, S., Foglia, E. E., DeMauro, S. B., Chawla, S., Brion, L. P., and Wyckoff, M. H. (2022). Perinatal management: Lessons learned from the neonatal research network. In "Seminars in Perinatology", pp. 151636. Elsevier.

Rossi, R. M., Hall, E., and DeFranco, E. A. (2019). Contemporary trends in cesarean delivery utilization for live births between 22 0/7 and 23 6/7 weeks of gestation. Obstetrics & Gynecology 133, 451-458.

Rysavy, M. A., Horbar, J. D., Bell, E. F., Li, L., Greenberg, L. T., Tyson, J. E., Patel, R. M., Carlo, W. A., Younge, N. E., and Green, C. E. (2020). Assessment of an updated neonatal research network extremely preterm birth outcome model in the Vermont Oxford Network. JAMA pediatrics 174, e196294-e196294.