Outcomes of outborn very-low-birth-weight infants in Japan.
Birth Setting
/ statistics & numerical data
Cerebral Intraventricular Hemorrhage
/ epidemiology
Female
Gestational Age
Humans
Infant, Extremely Premature
Infant, Newborn
Infant, Very Low Birth Weight
Intensive Care Units, Neonatal
Japan
/ epidemiology
Male
Obstetric Labor Complications
/ epidemiology
Pregnancy
Pregnancy Complications
/ epidemiology
Sex Factors
Transportation of Patients
/ statistics & numerical data
epidemiology
intensive care
neonatology
neurodisability
resuscitation
Journal
Archives of disease in childhood. Fetal and neonatal edition
ISSN: 1468-2052
Titre abrégé: Arch Dis Child Fetal Neonatal Ed
Pays: England
ID NLM: 9501297
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
25
11
2019
revised:
29
05
2020
accepted:
27
06
2020
pubmed:
14
8
2020
medline:
4
3
2021
entrez:
14
8
2020
Statut:
ppublish
Résumé
Outcomes of prenatal covariate-adjusted outborn very-low-birth-weight infants (VLBWIs) (≤1500 g) remain uncertain. To compare morbidity and mortality between outborn and inborn VLBWIs. Observational cohort study using inverse-probability-of-treatment weighting. Neonatal Research Network of Japan. Singleton VLBWIs with no major anomalies admitted to a neonatal intensive care unit from 2012 to 2016. Inverse-probability-of-treatment weighting with propensity scores was used to reduce imbalances in prenatal covariates (gestational age (GA), birth weight, small for GA, sex, maternal age, premature rupture of membranes, chorioamnionitis, preeclampsia, maternal diabetes mellitus, antenatal steroids and caesarean section). The primary outcome was severe intraventricular haemorrhage (IVH). The secondary outcomes were outcomes at resuscitation, other neonatal morbidities and mortality. The full cohort comprised 15 842 VLBWIs (668 outborns). The median (IQR) GA and birth weight were 28.9 (26.4-31.0) weeks and 1128 (862-1351) g for outborns and 28.7 (26.3-30.9) weeks and 1042 (758-1295) g for inborns. Outborn VLBWIs had a higher incidence of severe IVH (8.2% vs 4.1%; OR, 3.45; 95% CI 1.16 to 10.3) and pulmonary haemorrhage (3.7% vs 2.8%; OR, 5.21; 95% CI 1.41 to 19.2). There were no significant differences in Apgar scores, oxygen rates at delivery, intubation ratio at delivery, persistent pulmonary hypertension of the newborn, IVH of any grade, periventricular leukomalacia, chronic lung disease, oxygen at discharge, patent ductus arteriosus, retinopathy of prematurity, necrotising enterocolitis, sepsis or mortality. Outborn delivery of VLBWIs was associated with an increased risk of severe IVH.
Sections du résumé
BACKGROUND
BACKGROUND
Outcomes of prenatal covariate-adjusted outborn very-low-birth-weight infants (VLBWIs) (≤1500 g) remain uncertain.
OBJECTIVE
OBJECTIVE
To compare morbidity and mortality between outborn and inborn VLBWIs.
DESIGN
METHODS
Observational cohort study using inverse-probability-of-treatment weighting.
SETTING
METHODS
Neonatal Research Network of Japan.
PATIENTS
METHODS
Singleton VLBWIs with no major anomalies admitted to a neonatal intensive care unit from 2012 to 2016.
METHODS
METHODS
Inverse-probability-of-treatment weighting with propensity scores was used to reduce imbalances in prenatal covariates (gestational age (GA), birth weight, small for GA, sex, maternal age, premature rupture of membranes, chorioamnionitis, preeclampsia, maternal diabetes mellitus, antenatal steroids and caesarean section). The primary outcome was severe intraventricular haemorrhage (IVH). The secondary outcomes were outcomes at resuscitation, other neonatal morbidities and mortality.
RESULTS
RESULTS
The full cohort comprised 15 842 VLBWIs (668 outborns). The median (IQR) GA and birth weight were 28.9 (26.4-31.0) weeks and 1128 (862-1351) g for outborns and 28.7 (26.3-30.9) weeks and 1042 (758-1295) g for inborns. Outborn VLBWIs had a higher incidence of severe IVH (8.2% vs 4.1%; OR, 3.45; 95% CI 1.16 to 10.3) and pulmonary haemorrhage (3.7% vs 2.8%; OR, 5.21; 95% CI 1.41 to 19.2). There were no significant differences in Apgar scores, oxygen rates at delivery, intubation ratio at delivery, persistent pulmonary hypertension of the newborn, IVH of any grade, periventricular leukomalacia, chronic lung disease, oxygen at discharge, patent ductus arteriosus, retinopathy of prematurity, necrotising enterocolitis, sepsis or mortality.
CONCLUSION
CONCLUSIONS
Outborn delivery of VLBWIs was associated with an increased risk of severe IVH.
Identifiants
pubmed: 32788390
pii: archdischild-2019-318594
doi: 10.1136/archdischild-2019-318594
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
131-136Informations de copyright
© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.