Death or survival with major morbidity in VLBW infants born at Brazilian neonatal research network centers

Guinsburg, Ruth; Almeida, Maria Fernanda Branco de; Castro, Jarbas C.; Silveira, Rita C.; Caldas, Jamil Pedro de Siqueira; Fiori, Humberto Holmer; Vale, Marynéa Silva do; Abdallah, Vânia Olivetti Steffen; Cardoso, Laura Emilia Monteiro Bigélli; Filho, Navantino Alves; Moreira, Maria Elisabeth Lopes; Acquesta, Ana Lúcia; Ferrari, Lígia S L; Bentlin, Maria Regina; Venzon, Paulyne Stadler; Gonçalves‐Ferri, Walusa Assad; Meneses, Jucille; Diniz, Edna Maria de Albuquerque; Zanardi, Dulce M.; Santos, Cristina Nunes dos; Duarte, José L.B.; Rego, Maria Albertina Santiago

doi:10.3109/14767058.2015.1031740

Cited by 44 publications

(48 citation statements)

References 23 publications

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“…25 Thus, VLBW infant mortality has been reported to range between 12.4% and 28% as per the neonatal networks of developed countries (the Euro Neo Net/Euro-Peristat Network, 26 the Vermont-Oxford Network, 27 the Canadian Neonatal Network, 28 the National Institute of Child Health and Human Development [NICHD], 29 the Spanish Neonatology Society). 23 In contrast, the results obtained by the Brazilian Neonatal Research Network 30 and the Neonatology Network of Public Hospitals from the City of Buenos Aires 31 describe more unfavorable results, especially associated with a low use of antenatal corticosteroids. However, when analyzing such differences, it is necessary to consider the denominator used to estimate the mortality rate and the fact that inclusion criteria vary from one study to another, 32 in addition to differences in population, perinatal practices, and resources.…”

Section: Discussioncontrasting

confidence: 42%

Perinatal factors associated with neonatal mortality in very low birth weight infants: a multicenter study

2016

Arch Argent Pediat

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Introduction.Objectives. To assess risk factors associated with neonatal mortality in very low birth weight (VLBW) infants (≤ 1500 g) and the impact of the administration of antenatal corticosteroids. Population and methods. Retrospective analysis of a VLBW infant cohort from 26 tertiary care and teaching sites member of the South American Neonatal Network (NEOCOSUR), which includes Argentina, Brazil, Chile, Paraguay, Peru, and Uruguay, conducted between 2000 and 2011 on 11 455 records. Maternal and neonatal characteristics and morbidity were compared between deceased VLBW infants and those who survived to discharge. Outcome measures associated with neonatal mortality were established by logistic regression. The effect of antenatal corticosteroids on neonatal morbidity and mortality was estimated using the matching method. Results. The neonatal mortality rate was 22.3%, and variability among sites was elevated. Factors that were independently associated with a lower mortality of VLBW infants included the administration of antenatal corticosteroids (OR: 0.49, 95% CI: 0.43-0.54), a better birth weight Z-score (OR: 0.63, 0.61-0.65), arterial hypertension (OR: 0.67, 0.58-0.77), and C-section (OR: 0.75, 0.65-0.85). The matching method allowed reducing the risk of death by 38% in association with antenatal corticosteroids. Conclusions. Major perinatal factors were identified in association with neonatal mortality in VLBW infants, and the impact of antenatal corticosteroid use in the NEOCOSUR Network was demonstrated.

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Section: Discussioncontrasting

confidence: 42%

Perinatal factors associated with neonatal mortality in very low birth weight infants: a multicenter study

2016

Arch Argent Pediat

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“…The remaining 3 studies didn’t provide these details. [22, 23, 25] The large studies by Carlo et al and Mori et al provided data for all the outcomes included in the review at all the gestation[24, 28]. Guthrie et al provided the data only for the outcome of NEC.…”

Section: Resultsmentioning

confidence: 99%

“…Guthrie et al provided the data only for the outcome of NEC. [29] We obtained additional data on request from authors Mori et al, Bajwa et al and Guinsburg et al[23, 25, 28] We used the systematic review by Park et al for the data on Bader et al and Guthrie et al as we were unable to get it from the original authors. [12, 22, 29] Only 2 studies reported on long-term neurodevelopment at the corrected age of 12–24 months.…”

Section: Resultsmentioning

confidence: 99%

Antenatal corticosteroids for neonates born before 25 Weeks—A systematic review and meta-analysis

Deshmukh

Patole

2017

PLoS ONE

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BackgroundEfficacy of antenatal corticosteroids before 25 weeks of gestation is unclear.ObjectiveTo assess and compare neonatal outcomes following ANC exposure at 22, 23 and 24 weeks of gestation by conducting systematic review and meta- analysis.MethodsA systematic review of randomised controlled trials (RCT) and non-RCTs reporting on neonatal outcomes after exposure to ANC up to 246 weeks of gestation using the Cochrane systematic review methodology. Databases Pubmed, CINAHL, Embase, Cochrane Central library, and online abstracts of conference proceedings including the Pediatric Academic Society (PAS) were searched in Feb 2017. Primary outcome was in-hospital mortality defined as death before discharge during the first admission. Secondary outcomes included severe intraventricular hemorrhage (IVH> grade III and IV)/or periventricular leukomalacia (PVL), necrotising enterocolitis (NEC >stage II) and chronic lung disease (CLD). Meta-analysis was performed using a random-effects model. The level of evidence (LOE) was summarised using the GRADE guidelines.Main resultsThere were no RCTs; 8 high quality non-RCTs were included in the review. Meta-analysis showed reduction in mortality [N = 10109; OR = 0.47(0.39–0.56), p<0.00001; LOE: Moderate] and severe IVH and PVL [N = 5084; OR = 0.71(0.61–0.82), p<0.00001; LOE: Low] after exposure to ANC in neonates born <25 weeks. There was no significant difference in CLD [N = 4649; OR = 1.19(0.85–1.65) p = 0.31; LOE: Low] and NEC [N = 5403; OR = 0.95 (0.76–1.19) p = 0.65; LOE: Low]. Mortality was comparable in neonates born at 22, 23 or 24 weeks.ConclusionModerate to low quality evidence indicates that exposure to ANC is associated with reduction in mortality and IVH/or PVL in neonates born before 25 weeks.

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“…The secondary outcome was the presence of a fifth-minute Apgar score of 7–10. Given the chance of the primary outcome in the study centres to be approximately 50%,16 with a 10% difference between the studied groups and a power of 80%, it was necessary to include at least 387 infants in each group.…”

Section: Methodsmentioning

confidence: 99%

T-piece versus self-inflating bag ventilation in preterm neonates at birth

Guinsburg

Almeida

Castro

et al. 2017

Arch Dis Child Fetal Neonatal Ed

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Death or survival with major morbidity in VLBW infants born at Brazilian neonatal research network centers

Abstract: More than half of the VLBW infants born at public university level 3 Brazilian hospitals either die or survive with major morbidities.

Cited by 44 publications

References 23 publications

Perinatal factors associated with neonatal mortality in very low birth weight infants: a multicenter study

Perinatal factors associated with neonatal mortality in very low birth weight infants: a multicenter study

Antenatal corticosteroids for neonates born before 25 Weeks—A systematic review and meta-analysis

T-piece versus self-inflating bag ventilation in preterm neonates at birth

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