Aim The current study determined survival, short‐term neonatal morbidity and predictors for death or adverse outcome of very preterm infants in Austria. Methods This population‐based cohort study included 5197 very preterm infants (53.3% boys) born between 2011 and 2016 recruited from the Austrian Preterm Outcome Registry. Main outcome measures were gestational age‐related mortality and major short‐term morbidities. Results Overall, survival rate of all live‐born infants included was 91.6% and ranged from 47.1% and 73.4% among those born at 23 and 24 weeks of gestation to 84.9% and 88.2% among infants born at 25 and 26 weeks to more than 90.0% among those with a gestational age of 27 weeks or more. The overall prevalence of chronic lung disease, necrotising enterocolitis requiring surgery, intraventricular haemorrhage Grades 3–4, and retinopathy of prematurity Grades 3–5 was 10.0%, 2.1%, 5.5%, and 3.6%, respectively. Low gestational age, low birth weight, missing or incomplete course of antenatal steroids, male sex, and multiple births were significant risk predictors for death or adverse short‐term outcome. Conclusion In this national cohort study, overall survival rates were high and short‐term morbidity rate was low.

In our patient population, early mortality was higher for infants weighing less than 2.5 kg. However, within the low-weight group, lower weight at surgery or history of prematurity was not associated with a higher mortality or bad neurological outcome.

This prospective study investigates whether amino terminal proB-type natriuretic peptide (NT-proBNP) levels are elevated in neonates with congenital heart defect (CHD). NT-proBNP levels in the umbilical cord blood of 60 neonates with prenatally diagnosed CHD, in the cord blood of 200 control subjects, and in the plasma of the respective mothers were analyzed using an automated enzyme immunoassay. NT-proBNP concentrations in the cord blood of the CHD group were significantly elevated compared with controls [median (range): 158 pg/mL (378 -3631 pg/mL) and 626 pg/mL (153-2518 pg/mL); p value Ͻ0.001]. The NT-proBNP concentrations of the newborns and their mothers did correlate neither in the CHD nor in the control group. In 54 patients with CHD, NT-proBNP levels were measured on the median 5th day of life. They showed a significant increase (median 1665 pg/mL and 19222 pg/mL; p Ͻ 0.001). NT-proBNP levels in the cord blood of neonates with CHD are significantly elevated and show a marked increase in the first week of life. Furthermore, this study confirms previously published reference intervals of NT-proBNP in the cord blood of healthy neonates as well as the finding that there is no exchange of NTproBNP across the placenta. (Pediatr Res 66: 466-469, 2009) B rain-type natriuretic peptide (BNP) is a natriuretic hormone secreted from the cardiac ventricular myocytes in response to an increase in ventricular wall stretch and filling pressures (1). Furthermore, hypoxia has been shown to be a direct stimulus for secretion of BNP in human cardiac myocytes (2). On secretion from the cardiac myocyte, pro-BNP, the inactive precursor, is cleaved into the biologically active BNP and the amino terminal fragment (NT-proBNP). Several studies have shown an excellent correlation between BNP and NT-proBNP plasma levels of adults, children, and in umbilical cord blood (3-5).Concentrations of BNP and its biologically inactive fragment NT-proBNP are of high relevance in the diagnosis and treatment management of congestive heart failure in adults and children (3,6 -11). Both peptides are useful markers in a variety of cardiac diseases in children and adolescents (11)(12)(13)(14)(15)(16)(17)(18). It is well imaginable that also premature and newborn patients could benefit from the use of natriuretic peptide levels for diagnosis and treatment guidance of cardiac diseases.However, data on the usefulness of natriuretic peptides for diagnosis and management of congenital heart disease in this age group are limited. Even the published neonatal reference values show a variation depending on the kits used, the age at blood sampling, and the population studied (19 -25). There are several studies published on the role of natriuretic peptides in the management of patent ductus arteriosus (26 -30), persistent pulmonary hypertension of the newborn (31), as a marker of neonatal sepsis (32,33), and of left ventricular function (32,34). Previous investigations did neither show differences of NT-proBNP levels between arterial and venous cord b...

Nearly half of all infants suffered from any morbidity, and several risk factors were identified being significantly associated with NICU admission rate and length of hospitalization.

Kinder-und Jugendheilkunde (ÖGKJ) 2 Arbeitsgruppe für Ethik in der Kinder-und Jugendheilkunde der Österreichischen Gesellschaft für Kinder-und Jugendheilkunde (ÖGKJ)