Can the early condition at admission of a high‐risk infant aid in the prediction of mortality and poor neurodevelopmental outcome? A population study in Australia

Greenwood, Sarah; Abdel-Latif, Mohamed E; Bajuk, Barbara; Lui, Kei

doi:10.1111/j.1440-1754.2012.02430.x

Cited by 20 publications

(9 citation statements)

References 26 publications

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“…As expected, the VLBW study cohort held a disproportionately high number of SGA infants [6–8, 17, 42] in harmony with previous large population studies, which show SGA proportions of 20–39% in VLBW groups [10–13, 43, 44] compared to 8–12% in VLGA groups [15, 16, 45–47]. …”

Section: Discussionsupporting

confidence: 87%

Comparing very low birth weight versus very low gestation cohort methods for outcome analysis of high risk preterm infants

Koller-Smith

Shah

et al. 2017

BMC Pediatr

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BackgroundCompared to very low gestational age (<32 weeks, VLGA) cohorts, very low birth weight (<1500 g; VLBW) cohorts are more prone to selection bias toward small-for-gestational age (SGA) infants, which may impact upon the validity of data for benchmarking purposes.MethodData from all VLGA or VLBW infants admitted in the 3 Networks between 2008 and 2011 were used. Two-thirds of each network cohort was randomly selected to develop prediction models for mortality and composite adverse outcome (CAO: mortality or cerebral injuries, chronic lung disease, severe retinopathy or necrotizing enterocolitis) and the remaining for internal validation. Areas under the ROC curves (AUC) of the models were compared.ResultsVLBW cohort (24,335 infants) had twice more SGA infants (20.4% vs. 9.3%) than the VLGA cohort (29,180 infants) and had a higher rate of CAO (36.5% vs. 32.6%). The two models had equal prediction power for mortality and CAO (AUC 0.83), and similarly for all other cross-cohort validations (AUC 0.81–0.85). Neither model performed well for the extremes of birth weight for gestation (<1500 g and ≥32 weeks, AUC 0.50–0.65; ≥1500 g and <32 weeks, AUC 0.60–0.62).ConclusionThere was no difference in prediction power for adverse outcome between cohorting VLGA or VLBW despite substantial bias in SGA population. Either cohorting practises are suitable for international benchmarking.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-017-0921-x) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 87%

Comparing very low birth weight versus very low gestation cohort methods for outcome analysis of high risk preterm infants

Koller-Smith

Shah

et al. 2017

BMC Pediatr

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“…To the best of our knowledge, no previous studies assessed the role of this predictor on time to FEF in preterm infants. CRIB II score, which provides a recalibrated and simplified scoring system that avoids the potential problems of early treatment bias [32], has been used to date to predict mortality and neurodevelopmental outcome [50], [51].…”

Section: Discussionmentioning

confidence: 99%

Predictors of Full Enteral Feeding Achievement in Very Low Birth Weight Infants

et al. 2014

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BackgroundTo elucidate the role of prenatal, neonatal and early postnatal variables in influencing the achievement of full enteral feeding (FEF) in very low birth weight (VLBW) infants and to determine whether neonatal intensive care units (NICUs) differ in this outcome.MethodsPopulation-based retrospective cohort study using data on 1,864 VLBW infants drawn from the “Emilia-Romagna Perinatal Network” Registry from 2004 to 2009. The outcome of interest was time to FEF achievement. Eleven prenatal, neonatal and early postnatal variables and the study NICUs were selected as potential predictors of time to FEF. Parametric survival analysis was used to model time to FEF as a function of the predictors. Marginal effects were used to obtain adjusted estimates of median time to FEF for specific subgroups of infants.ResultsLower gestational age, exclusive formula feeding, higher CRIB II score, maternal hypertension, cesarean delivery, SGA and PDA predicted delayed FEF. NICUs proved to be heterogeneous in terms of FEF achievement. Newborns with PDA had a 4.2 days longer predicted median time to FEF compared to those without PDA; newborns exclusively formula-fed had a 1.4 days longer time to FEF compared to those fed human milk.ConclusionsThe results of our study suggest that time to FEF is influenced by clinical variables and NICU-specific practices. Knowledge of the variables associated with delayed/earlier FEF achievement could help in improving specific aspects of routine clinical management of VLBW infants and to reduce practice variability.

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“…Another study using a large sample drawn for the years 1998-2003 from the same NSW data collection as this study evaluated the prediction of poor neurodevelopmental outcome by CRIB-II scores and found they did not perform better than gestational age or birthweight. 23 The severity of illness scores by themselves might not be good predictors of neurodisability; however, inclusion in a multivariable model for prediction of long-term morbidity might be useful.…”

Section: 6%mentioning

confidence: 99%

Comparing CRIB‐II and SNAPPE‐II as mortality predictors for very preterm infants

Reid

Bajuk

Lui

et al. 2014

J Paediatrics Child Health

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Can the early condition at admission of a high‐risk infant aid in the prediction of mortality and poor neurodevelopmental outcome? A population study in Australia

Abstract: CRIB-II improved prediction of mortality but did not perform better than gestational age or BW in predicting FD. We would caution clinicians against using the infant's condition at admission to predict long-term outcome.

Cited by 20 publications

References 26 publications

Comparing very low birth weight versus very low gestation cohort methods for outcome analysis of high risk preterm infants

Comparing very low birth weight versus very low gestation cohort methods for outcome analysis of high risk preterm infants

Predictors of Full Enteral Feeding Achievement in Very Low Birth Weight Infants

Comparing CRIB‐II and SNAPPE‐II as mortality predictors for very preterm infants

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