Cause of Preterm Birth as a Prognostic Factor for Mortality

Delorme, Pierre; Goffinet, François; Ancel, Pierre‐Yves; Foix‐L’Hélias, L.; Langer, B.; Lebeaux, Cécile; Marchand, Laëtitia; Zeitlin, Jennifer; Ego, Anne; Arnaud, Catherine; Vayssière, Christophe; Lorthe, Elsa; Durrmeyer, Xavier; Sentilhes, Loïc; Subtil, D.; Debillon, Thierry; Winer, Norbert; Kaminski, Monique; D’ercole, C.; Dreyfus, Michel; Carbonne, Bruno; Kayem, Gilles

doi:10.1097/aog.0000000000001179

Cited by 66 publications

(42 citation statements)

References 25 publications

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“…In keeping with previously published studies, we found a decrease in in‐hospital mortality for neonates with RDS with a decline in the incidence of the combined outcome of BPD/death, both for the entire study population and those ≤28 weeks, the latter being comparable to the rates of 45‐51% reported by others . The overall mortality rate in our study is higher than that of France and Japan but lower than other industrialized countries such as Australia‐New Zealand, Canada, United Kingdom, Switzerland, and Spain for neonates <1500 g and 24‐31 6/7 weeks GA but these differences could be due to the different GA age cut offs used for these studies. It is likely that the decline in the in‐hospital mortality is due to advances in perinatal and neonatal care along with increased use of antenatal corticosteroids and surfactant, the provision of parenteral nutrition, increased use of breast milk, and a decrease in late onset sepsis .…”

Section: Discussionsupporting

confidence: 91%

Trends in epidemiology and outcomes of respiratory distress syndrome in the United States

Donda

Vijayakanthi

Dapaah‐Siakwan

et al. 2019

Pediatric Pulmonology

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Background: The management practices of Respiratory Distress Syndrome (RDS) in the newborn have changed over time. We examine the trends in the epidemiology, resource utilization, and outcomes (mortality and bronchopulmonary dysplasia [BPD]) of RDS in preterm neonates ≤34 weeks gestational age (GA) in the United States.Methods: In this retrospective serial cross-sectional study, we used ICD-9 codes to classify preterm infants GA ≤34 weeks between 2003 and 2014 from the National Inpatient Sample as having RDS or not. Trends in the prevalence of infants defined as RDS by ICD-9 code (ICD9-RDS), length of stay, BPD, and mortality were analyzed using Cochran-Armitage and Jonckheere-Terpstra tests and multivariable logistic regression.Results: Of 1 526 186 preterm live births with GA ≤34 weeks, 554 409 had ICD9-RDS (260 cases per 1000 live births) with the prevalence increasing from 170 to 361 (P trend < 0.001) and associated decrease in all-cause mortality (7.6% to 6.1%; P trend < 0.001) from 2003 to 2014. Increased utilization of non-invasive mechanical ventilation (NIMV) (69.5% to 74.3%; P trend < 0.001) was associated with decreased invasive mechanical ventilation (IMV) use >96 h (60.4 to 56.6%; P trend < 0.001). Exclusive NIMV use increased from 16.8% to 29.1% (P trend < 0.0001). BPD incidence decreased from 14% to 12.5% (P trend < 0.001). LOS increased from 32 days to 38 days (P trend < 0.001) and cost increased from $49,521 to $55,394 (P trend < 0.001).Conclusion: From 2003 to 2014, the assigned ICD9-RDS diagnosis, and utilization of NIMV increased and mortality among infants assigned the ICD9-RDS diagnosis decreased. With higher survival, hospital cost increased incrementally, indicating the importance of ongoing analysis of appropriate reimbursement for the care provided at tertiary centers for preterm infants. K E Y W O R D S bronchopulmonary dysplasia, epidemiology, invasive mechanical ventilation, national inpatient sample, non-invasive mechanical ventilation, respiratory distress syndrome Abbreviation: AHRQ, agency for healthcare research and quality; BPD, bronchopulmonary dysplasia; CI, confidence interval; HCUP, healthcare cost and utilization project; ICD-9-CM, International Classification of Diseases, Ninth edition, clinical modification; IMV, invasive positive pressure ventilation; NIMV, non-invasive mechanical ventilation; NIS, national inpatient sample; PN, preterm neonates; RDS, respiratory distress syndrome; TTN, transient tachypnea of the newborn.This study was presented in part as a poster abstract at the

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Section: Discussionsupporting

confidence: 91%

Trends in epidemiology and outcomes of respiratory distress syndrome in the United States

Donda

Vijayakanthi

Dapaah‐Siakwan

et al. 2019

Pediatric Pulmonology

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“…Our analysis showed that this condition was related to poor functioning, as expressed in higher WHODAS‐36 scores. We can speculate that women with hypertension may experience not only acute complications (placental abruption, pulmonary edema, stroke), but also the need to control blood pressure postpartum (and later in life) and the need to deal with the consequences of premature birth, since there is an increased risk of a medically indicated preterm birth among these women . Most likely, these factors had an impact on functionality.…”

Section: Discussionmentioning

confidence: 99%

“…We can speculate that women with hypertension may experience not only acute complications (placental abruption, pulmonary edema, stroke), but also the need to control blood pressure postpartum (and later in life) and the need to deal with the consequences of premature birth, since there is an increased risk of a medically indicated preterm birth among these women. 18 Most likely, these factors had an impact on functionality. Another study, conducted in Malaysia using a different psychometric tool, showed that women who experienced SMM had lower functional ability 1 month postpartum, but the difference disappeared after 6 months.…”

Section: Discussionmentioning

confidence: 99%

The impact of hypertension, hemorrhage, and other maternal morbidities on functioning in the postpartum period as assessed by the WHODAS 2.0 36-item tool

Guida

Costa

Parpinelli

et al. 2018

Int J Gynecol Obstet

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ObjectiveTo assess the scores of postpartum women using the WHO Disability Assessment Schedule 2.0 36‐item tool (WHODAS‐36), considering different morbidities.MethodsSecondary analysis of a retrospective cohort of women who delivered at a referral maternity in Brazil and were classified with and without severe maternal morbidity (SMM). WHODAS‐36 was used to assess functioning in postpartum women. Percentile distribution of total WHODAS score was compared across three groups: Percentile (P)<10, 1090. Cases of SMM were categorized and WHODAS‐36 score was assessed according to hypertension, hemorrhage, or other conditions.ResultsA total of 638 women were enrolled: 64 had mean scores below P<10 (1.09) and 66 were above P>90 (41.3). Of women scoring above P>90, those with morbidity had a higher mean score than those without (44.6% vs 36.8%, P=0.879). Women with higher WHODAS‐36 scores presented more complications during pregnancy, especially hypertension (47.0% vs 37.5%, P=0.09). Mean scores among women with any complication were higher than those with no morbidity (19.0 vs 14.2, P=0.01). WHODAS‐36 scores were higher among women with hypertensive complications (19.9 vs 16.0, P=0.004), but lower among those with hemorrhagic complications (13.8 vs 17.7, P=0.09).ConclusionsComplications during pregnancy, childbirth, and the puerperium increase long‐term WHODAS‐36 scores, demonstrating a persistent impact on functioning among women, up to 5 years postpartum.

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“…We chose to compare the neonatal outcomes among different groups of preterm births using a hierarchical system that was sorted by severity and probability as a cause of preterm birth. Delorme et al used a similar hierarchical classification for the probable causes of preterm birth in a study of neonatal mortality that focused on preterm infants below 34 gestational weeks. As we did not want infants with malformations to affect the results in the other groups, these were placed in group number one.…”

Section: Discussionmentioning

confidence: 99%

Underlying maternal and pregnancy‐related conditions account for a substantial proportion of neonatal morbidity in late preterm infants

et al. 2018

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Cause of Preterm Birth as a Prognostic Factor for Mortality

Abstract: Among neonates born alive before 34 weeks of gestation, only those born because of suspected fetal growth restriction have a higher mortality risk than those born after preterm labor.

Cited by 66 publications

References 25 publications

Trends in epidemiology and outcomes of respiratory distress syndrome in the United States

Trends in epidemiology and outcomes of respiratory distress syndrome in the United States

The impact of hypertension, hemorrhage, and other maternal morbidities on functioning in the postpartum period as assessed by the WHODAS 2.0 36-item tool

Underlying maternal and pregnancy‐related conditions account for a substantial proportion of neonatal morbidity in late preterm infants

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