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Swiss medical centres vary significantly when it comes to outcomes of neonates with a very low gestational age
Author(s) -
Steurer Martina A.,
Adams Mark,
Bacchetti Peter,
Schulzke Sven M.,
RothKleiner Matthias,
Berger Thomas M.
Publication year - 2015
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.13047
Subject(s) - medicine , retinopathy of prematurity , bronchopulmonary dysplasia , gestational age , pediatrics , logistic regression , cohort , sepsis , birth weight , cohort study , pregnancy , enterocolitis , obstetrics , surgery , biology , genetics
Aim This study quantified the impact of perinatal predictors and medical centre on the outcome of very low‐gestational‐age neonates ( VLGAN s) born at <32 completed weeks in Switzerland. Methods Using prospectively collected data from a 10‐year cohort of VLGAN s, we developed logistic regression models for three different time points: delivery, NICU admission and seven days of age. The data predicted survival to discharge without severe neonatal morbidity, such as major brain injury, moderate or severe bronchopulmonary dysplasia, retinopathy of prematurity (≥stage three) or necrotising enterocolitis (≥stage three). Results From 2002 to 2011, 6892 VLGAN s were identified: 5854 (85%) of the live‐born infants survived and 84% of the survivors did not have severe neonatal complications. Predictors for adverse outcome at delivery and on NICU admission were low gestational age, low birthweight, male sex, multiple birth, birth defects and lack of antenatal corticosteroids. Proven sepsis was an additional risk factor on day seven of life. The medical centre remained a statistically significant factor at all three time points after adjusting for perinatal predictors. Conclusion After adjusting for perinatal factors, the survival of Swiss VLGAN s without severe neonatal morbidity was strongly influenced by the medical centre that treated them.