Association Between Year of Birth and 1-Year Survival Among Extremely Preterm Infants in Sweden During 2004-2007 and 2014-2016

Norman, Mikael; Hallberg, Boubou; Abrahamsson, Thomas; Björklund, Lars; Domellöf, Magnus; Farooqi, Aijaz; Bruun, Cathrine Foyn; Gadsbøll, Christian; Hellström‐Westas, Lena; Ingemansson, Fredrik; Källén, Karin; Ley, David; Maršál, Karel; Normann, Erik; Serenius, Fredrik; Stephansson, Olof; Stigson, Lennart; Um-Bergström, Petra; Håkansson, Stellan

doi:10.1001/jama.2019.2021

Cited by 224 publications

(152 citation statements)

References 42 publications

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“…Over 90% of fetuses in our cohort were admitted to NICU, and three quarters of the total population survived to discharge. This is in keeping with results from Sweden 28 , 29 and Japan 30 , 31 although of course our numbers are smaller and confidence intervals therefore wider. In England, the EPICure studies demonstrated increased admissions to NICU between 1995 and 2006 1 , probably linked to an increase in the numbers of babies born at these gestations as well as to changes in attitudes in the delivery room 32 .…”

Section: Discussionsupporting

confidence: 90%

Maternal and infant morbidity following birth before 27 weeks of gestation: a single centre study

Morgan

Waheed

Gajree

et al. 2021

Sci Rep

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Delivery at extreme preterm gestational ages (GA) $$<\;27$$ < 27 weeks is challenging with limited evidence often focused only on neonatal outcomes. We reviewed management and short term maternal, fetal and neonatal outcomes of births for 132 women (22 + 0 to 26 + 6 weeks’ GA) with a live fetus at admission to hospital and in labour or at planned emergency Caesarean section: 103 singleton and 29 (53 live fetuses) twin gestations. Thirty women (23%) had pre-existing medical problems, 110 (83%) had antenatal complications; only 17 (13%) women experienced neither. Major maternal labour and delivery complications affected 35 women (27%). 151 fetuses (97%) were exposed to antenatal steroids, 24 (15%) to tocolysis and 70 (45%) to magnesium sulphate. Delivery complications affected 11 fetuses, with 12 labour or delivery room deaths; survival to discharge was 75% (117/156), increasing with GA: 25% (1/4), 75% (18/24), 69% (29/42), 73% (33/45) and 88% (36/41) at 22, 23, 24, 25 and 26 weeks GA respectively (p = 0.024). No statistically important impact was seen from twin status, maternal illness or obstetric management. Even in a specialist perinatal unit antenatal and postnatal maternal complications are common in extreme preterm births, emphasising the need to include maternal as well as neonatal outcomes.

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Section: Discussionsupporting

confidence: 90%

Maternal and infant morbidity following birth before 27 weeks of gestation: a single centre study

Morgan

Waheed

Gajree

et al. 2021

Sci Rep

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“…At baseline, Sweden provides healthcare at minimal cost to all inhabitants including mental health services (39,40). Moreover, Sweden is among the countries with the lowest rates of preterm births (between 5-6%) (41), likely due to the economic stability of the country and the focus of the government on perinatal health, as well as on the timely and adequate access to healthcare services (42). Despite the fact that the Swedish COVID-19 strategy did not include a general lockdown, but was instead based on voluntary social distancing guidelines (16), we still find a clear association of theCOVID-19 pandemic with the mental health of pregnant women.…”

Section: Previous Literaturementioning

confidence: 99%

Mental health among pregnant women during the pandemic in Sweden– a mixed methods approach using data from the Mom2B mobile application for research

Fransson

Karalexi

Kimmel

et al. 2020

Preprint

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Public health emergencies such as the coronavirus (SARS-CoV-2) pandemic have significant impact on mental health, and have been shown to impact on already prevalent affective disorders during and after pregnancy. The aim of this study was to utilize modern tools to assess depressive and anxiety symptoms, as well as wellbeing and life changes in pregnant women during the pandemic in Sweden, where no lockdown has been in place.Data from the Mom2B, a national ongoing mobile application-based study of pregnant and newly-delivered women were utilized. Participants (n= 1345) filled out self-report screeners of depression, anxiety and wellbeing. Questions about COVID symptoms and effects on life and health care were added from March 2020. Movement data was collected using the phone’s GPS sensor. Mood scores were compared with throughout the months of 2020 and to the levels of a previous collected material. Highest levels of depression and anxiety were evident in April and October 2020. Symptoms were higher among those feeling socially isolated, but not for those infected or with symptomatic family members. Wellbeing and mobility were strongly positively correlated and were lowest in April. Women reported on cancelled healthcare appointments and worry about their partners being absent from the delivery.The Mom2B application enabled gathering information at a national level in real-time as the pandemic has been evolving. Levels of perinatal affective symptoms and low wellbeing were elevated compared with previous years as well as with months with fewer cases of SARS-Cov-2. Similar applications can help healthcare providers and governmental bodies to in real time monitor high-risk groups during crises, as well as to adjust measures and the support offered.FundingThis project was funded by the Uppsala Region to AS, the Swedish Association of Local Authorities and Regions (SKR) to the department of Obstetrics and Gynecology, Akademiska University Hospital, the Swedish Research Council (Grant number 2020-01965) to AS, as well as the Fredrik and Inger Thuring’s Foundation to EF.

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“…As survival rates following preterm birth increase with medical advances, more becomes known about the developmental outcomes of children born preterm ( 7 ). Children are considered preterm if they were born prior to or during the thirty-sixth week of gestation and full-term if they were born between the thirty-seventh and forty-second weeks of gestation ( 8 ).…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Children Born Preterm and Full-Term on the Autism Spectrum in a Prospective Community Sample

Luu¹,

Jellett²,

Yaari³

et al. 2020

Front. Neurol.

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Introduction: Previous research suggests children diagnosed with autism spectrum disorder (ASD or “autism”) born extremely and very preterm face substantially delayed development than their peers born full-term. Further, children born preterm are proposed to show a unique behavioral phenotype, which may overlap with characteristics of autism, making it difficult to disentangle their clinical presentation. To clarify the presentation of autism in children born preterm, this study examined differences in key indicators of child development (expressive language, receptive language, fine motor, and visual reception) and characteristics of autism (social affect and repetitive, restricted behaviors).Materials and Methods: One fifty-eight children (136 full-term, twenty-two preterm) diagnosed with autism, aged 22–34 months, were identified prospectively using the Social Attention and Communication Surveillance tools during community-based, developmental surveillance checks in the second year of life. Those identified at “high likelihood” of an autism diagnosis were administered the Mullen Scales of Early Learning and the Autism Diagnostic Observation Schedule.Results: The children born preterm and full-term did not differ significantly in their fine motor, visual reception, expressive language, or receptive language skills. No significant differences in social affect and repetitive and restrictive behavior traits were found.Discussion: The findings of this study differs from previous research where children diagnosed with autism born very or extremely preterm were developmentally delayed and had greater autistic traits than their term-born peers. These null findings may relate to the large proportion of children born moderate to late preterm in this sample. This study was unique in its use of a community-based, prospectively identified sample of children diagnosed with autism at an early age. It may be that children in these groups differ from clinic- and hospital-based samples, that potential differences emerge later in development, or that within the autism spectrum, children born preterm and full-term develop similarly. It was concluded that within the current sample, at 2 years of age, children diagnosed with autism born preterm are similar to their peers born full-term. Thus, when clinicians identify characteristics of autism in children born preterm, it is important to refer the child for a diagnostic assessment for autism.

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Association Between Year of Birth and 1-Year Survival Among Extremely Preterm Infants in Sweden During 2004-2007 and 2014-2016

Abstract: Since 2004Since -2007, national guidelines and recommendations have been developed for the management of extremely preterm births in Sweden. If and how more uniform management has affected infant survival is unknown.

Cited by 224 publications

References 42 publications

Maternal and infant morbidity following birth before 27 weeks of gestation: a single centre study

Maternal and infant morbidity following birth before 27 weeks of gestation: a single centre study

Mental health among pregnant women during the pandemic in Sweden– a mixed methods approach using data from the Mom2B mobile application for research

A Comparison of Children Born Preterm and Full-Term on the Autism Spectrum in a Prospective Community Sample

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