Mortality and severe morbidity of very preterm infants: comparison of two French cohort studies.
Bronchopulmonary dysplasia
Cohort studies
Intraventricular haemorrhage
Morbidity
Mortality
Necrotising enterocolitis
Periventricular leukomalacia
Preterm
Retinopathy of prematurity
Very low birth weight
Journal
BMC pediatrics
ISSN: 1471-2431
Titre abrégé: BMC Pediatr
Pays: England
ID NLM: 100967804
Informations de publication
Date de publication:
17 10 2019
17 10 2019
Historique:
received:
15
05
2019
accepted:
29
08
2019
entrez:
19
10
2019
pubmed:
19
10
2019
medline:
23
10
2020
Statut:
epublish
Résumé
In Reunion Island, a French overseas department, the burden of preterm birth and perinatal mortality exceed those observed in mainland France, despite similar access to standard perinatal care. The purpose of the study was to compare the outcome of two cohorts of NICU-admitted very preterm infants born between 24 and 31 weeks of gestation (WG): the registry-based OGP (Observatoire de la Grande Prématurité, Reunion Island, 2008-2013) cohort, and the nationwide EPIPAGE-2 (mainland France, 2011) observational cohort. The primary outcome was adverse neonatal outcomes defined as a composite indicator of in-hospital mortality or any of three following severe morbidities: bronchopulmonary dysplasia (BPD), necrotising enterocolitis, or severe neurological injury (periventricular leukomalacia or grade III-IV intraventricular haemorrhages). Logistic regression modelling adjusting for confounders was performed. A total of 1272 very preterm infants from the Reunionese OGP cohort and 3669 peers from the mainland EPIPAGE-2 cohort were compared. Adverse neonatal outcomes were more likely observed in the OGP cohort (32.6% versus 26.6%, p < 0.001), as result of both increased in-hospital mortality across all gestational age strata and increased BPD among the survivors of the 29-31 WG stratum. After adjusting for gestational age, gender and multiple perinatal factors, the risk of adverse neonatal outcomes was higher in the OGP cohort than in the EPIPAGE-2 cohort across all gestational age strata. Despite similar guidelines for standard perinatal care, very preterm infants born in Reunion Island have a higher risk for death or severe morbidity compared with those born in mainland France.
Sections du résumé
BACKGROUND
In Reunion Island, a French overseas department, the burden of preterm birth and perinatal mortality exceed those observed in mainland France, despite similar access to standard perinatal care. The purpose of the study was to compare the outcome of two cohorts of NICU-admitted very preterm infants born between 24 and 31 weeks of gestation (WG): the registry-based OGP (Observatoire de la Grande Prématurité, Reunion Island, 2008-2013) cohort, and the nationwide EPIPAGE-2 (mainland France, 2011) observational cohort.
METHODS
The primary outcome was adverse neonatal outcomes defined as a composite indicator of in-hospital mortality or any of three following severe morbidities: bronchopulmonary dysplasia (BPD), necrotising enterocolitis, or severe neurological injury (periventricular leukomalacia or grade III-IV intraventricular haemorrhages). Logistic regression modelling adjusting for confounders was performed.
RESULTS
A total of 1272 very preterm infants from the Reunionese OGP cohort and 3669 peers from the mainland EPIPAGE-2 cohort were compared. Adverse neonatal outcomes were more likely observed in the OGP cohort (32.6% versus 26.6%, p < 0.001), as result of both increased in-hospital mortality across all gestational age strata and increased BPD among the survivors of the 29-31 WG stratum. After adjusting for gestational age, gender and multiple perinatal factors, the risk of adverse neonatal outcomes was higher in the OGP cohort than in the EPIPAGE-2 cohort across all gestational age strata.
CONCLUSIONS
Despite similar guidelines for standard perinatal care, very preterm infants born in Reunion Island have a higher risk for death or severe morbidity compared with those born in mainland France.
Identifiants
pubmed: 31623604
doi: 10.1186/s12887-019-1700-7
pii: 10.1186/s12887-019-1700-7
pmc: PMC6796444
doi:
Types de publication
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
360Références
JAMA. 2015 Jun 23-30;313(24):2441-8
pubmed: 26103028
Arch Dis Child Fetal Neonatal Ed. 2017 Mar;102(2):F153-F161
pubmed: 27531224
Arch Pediatr. 2013 Sep;20(9):928-37
pubmed: 23829969
Obstet Gynecol. 2004 Jun;103(6):1294-9
pubmed: 15172867
JAMA. 2010 Sep 1;304(9):992-1000
pubmed: 20810377
Arch Dis Child Fetal Neonatal Ed. 2010 Jan;95(1):F30-5
pubmed: 19723619
J Pediatr. 2012 Apr;160(4):578-583.e2
pubmed: 22048041
Pediatrics. 2012 Oct;130(4):e957-65
pubmed: 22966031
BMC Pediatr. 2014 Apr 09;14:97
pubmed: 24716860
Cochrane Database Syst Rev. 2017 Mar 21;3:CD004454
pubmed: 28321847
JAMA Pediatr. 2015 Mar;169(3):230-8
pubmed: 25621457
Arch Dis Child. 2017 Jan;102(1):97-102
pubmed: 27512082
Pediatrics. 2005 Dec;116(6):1353-60
pubmed: 16322158
Pediatrics. 2007 Oct;120(4):e815-25
pubmed: 17908739
Clin Perinatol. 2003 Jun;30(2):363-87
pubmed: 12875360
Pediatrics. 2004 Jul;114(1):58-64
pubmed: 15231908
J Matern Fetal Neonatal Med. 2016 Sep;29(18):3035-40
pubmed: 26512885
N Engl J Med. 2017 Feb 16;376(7):617-628
pubmed: 28199816
Pediatrics. 2009 Sep;124(3):866-74
pubmed: 19706571
Pediatrics. 2006 Dec;118(6):e1836-44
pubmed: 17142505
Semin Fetal Neonatal Med. 2018 Dec;23(6):374-379
pubmed: 30115546
J Pediatr. 2012 Jan;160(1):49-53.e1
pubmed: 21868028
J Epidemiol Community Health. 2016 Jun;70(6):609-15
pubmed: 26719590
JAMA. 2015 Sep 8;314(10):1039-51
pubmed: 26348753
Arch Dis Child Fetal Neonatal Ed. 2009 May;94(3):F158-63
pubmed: 18805823
Arch Dis Child Fetal Neonatal Ed. 2019 Mar;104(2):F128-F136
pubmed: 29907614
J Paediatr Child Health. 2015 Sep;51(9):881-8
pubmed: 25808827