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Risk factors associated with outcomes of very low birthweight infants in four A sian countries
Author(s) -
Wariki Windy Mariane Virenia,
Mori Rintaro,
Boo NemYun,
Cheah Irene Guat Sim,
Fujimura Masanori,
Lee Jiun,
Wong Kar Yin
Publication year - 2013
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.12054
Subject(s) - medicine , odds ratio , confidence interval , logistic regression , low birth weight , pediatrics , intensive care , incidence (geometry) , neonatology , risk factor , demography , intensive care medicine , pregnancy , genetics , physics , optics , biology , sociology
Aim The study aims to determine the risk factors associated with mortality and necrotising enterocolitis ( NEC ) among very low birthweight infants in 95 neonatal intensive care units in the A sian N etwork on M aternal and N ewborn H ealth. Methods This is a cross‐sectional study using an international collaborative database of 17 595 very low birthweight infants admitted within 28 days of birth between 2003 and 2006 in four A sian countries. Information on the mortality and morbidity of neonates admitted to the neonatal intensive care units was recorded. Factors associated with the death and diseases of infants were estimated using multilevel multivariate logistic regression. Random effects were included to account for the clustering of the observations. Results Overall discharge mortality was 15% and it was significantly different by countries and units. The mortality rate was found to be significantly higher in neonates with pulmonary haemorrhage (odds ratio 1.83, 95% confidence interval 1.63–2.04) and air leak syndrome (odds ratio 1.51, 95% confidence interval 1.30–1.72). The incidence of NEC was 4.3% and was strongly associated with other morbidities. Multivariate logistic regression showed that patent ductus arteriosus was the most significant risk factor associated with NEC . Conclusions Our analysis has highlighted the great potential that multi‐country, collaborative datasets have in terms of epidemiologic research when it comes to identifying issues in perinatal health that are common throughout A sia, and in relation to particular issues pertaining to specific countries and neonatal units. Establishing collaborative networks, conducting analyses of common datasets and further epidemiologic research are now essential measures to improve newborn health in Asia.