Major determinants of survival and length of stay in the neonatal intensive care unit of newborns from women with premature preterm rupture of membranes

Eken, Meryem; Tüten, Abdülhamit; Özkaya, Enis; Karatekın, Güner; Karateke, Ateş

doi:10.1080/14767058.2016.1235696

Cited by 23 publications

(13 citation statements)

References 20 publications

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“…Of these studies, four were prospective studies ( 24 – 27 ) and the remaining 19 studies were retrospective ( 1 , 9 , 18 , 28 – 43 ), of which 14 were multicenter studies ( 9 , 24 , 25 , 27 – 29 , 31 , 33 – 35 , 37 – 39 , 42 ) and 9 were single-center studies ( 1 , 18 , 26 , 30 , 32 , 36 , 40 , 41 , 43 ). The sample size ranged from 191 to 7,60,037.…”

Section: Resultsmentioning

confidence: 99%

Risk factors for length of NICU stay of newborns: A systematic review

Song

et al. 2023

Front. Pediatr.

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BackgroundThe improvement in survival of preterm infants is accompanied by an increase in neonatal intensive care unit (NICU) admissions. Prolonged length of stay in the NICU (LOS-NICU) increases the incidence of neonatal complications and even mortality and places a significant economic burden on families and strain on healthcare systems. This review aims to identify risk factors influencing LOS-NICU of newborns and to provide a basis for interventions to shorten LOS-NICU and avoid prolonged LOS-NICU.MethodsA systematic literature search was conducted in PubMed, Web of Science, Embase, and Cochrane library for studies that were published in English from January 1994 to October 2022. The PRISMA guidelines were followed in all phases of this systematic review. The Quality in Prognostic Studies (QUIPS) tool was used to assess methodological quality.ResultsTwenty-three studies were included, 5 of which were of high quality and 18 of moderate quality, with no low-quality literature. The studies reported 58 possible risk factors in six broad categories (inherent factors; antenatal treatment and maternal factors; diseases and adverse conditions of the newborn; treatment of the newborn; clinical scores and laboratory indicators; organizational factors).ConclusionsWe identified several of the most critical risk factors affecting LOS-NICU, including birth weight, gestational age, sepsis, necrotizing enterocolitis, bronchopulmonary dysplasia, and retinopathy of prematurity. As only a few high-quality studies are available at present, well-designed and more extensive prospective studies investigating the risk factors affecting LOS-NICU are still needed in the future.

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Section: Resultsmentioning

confidence: 99%

Risk factors for length of NICU stay of newborns: A systematic review

Song

et al. 2023

Front. Pediatr.

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“…Respiratory distress syndrome (RDS) remains the most important determinant of increasing neonatal morbidity in preterm infants [1] . A low secretory capacity of the adrenal cortex may cause a diminished stress response during the acute illness in preterm infants and could lead to increased morbidity in these infants [2] .…”

Section: Introductionmentioning

confidence: 99%

Antenatal Steroid in Preterm Infants with Respiratory Distress Syndrome

Gabr¹,

Fouad²

2022

The Egyptian Journal of Hospital Medicine

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Background: Respiratory distress syndrome (RDS) remains the most important determinant of increasing neonatal morbidity in preterm infants. A low secretory capacity of the adrenal cortex may cause a diminished stress response during the acute illness in preterm infants and could lead to increased morbidity in these infants. Objective: To evaluate the levels of antenatal steroid (cortisol) in the 1 st and 3 rd days of life in preterm neonates with respiratory distress syndrome. Patients and methods: This study was carried out in neonatal intensive care unit (NICU) of Benha University Hospital from June, 2020 to January, 2022. The study included 45 preterm neonates (23 females and 22 males), with gestational age ranged from 30 to 36 weeks, and their weights ranged between 1.100 kg to 2.700 kg (all of them were appropriate for gestational age (AGA) with mean weight 1.800 + 0.300 kg).Results: In the current study, in ROC curve and area under the curve shows that 3 rd day serum cortisol significantly could be used as a predictive measure in cases prognosis with probability of 71% that the assay result for a randomly chosen positive case will exceed the result for a randomly chosen negative case. Among respiratory distress groups (2 and 3) 3 rd day serum cortisol level of 485.5 (nmol/l) was chosen as a cutoff point below which cases with respiratory distress tend to show improvement in prognosis with sensitivity of 80% and specificity of 80%. Conclusion: Preterm infants with severe RDS (mechanically ventilated) release more cortisol, which could be the result of severe stress associated with respiratory distress and positive pressure ventilation. Increased incidence and severity of RDS were noticed more in cesarean section (CS) than in vaginal delivery (VD). Antenatal steroids have effective role in decreasing incidence and severity of RDS.

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“…Investigators have explored alternative outcome measures, such as the length of time a patient requires care in an intensive care unit (ICU) (eg, ICU days or days on mechanical ventilation) 11–14 . However, a shorter ICU stay may result from either a rapid recovery or an early death 15–20 …”

Section: Introductionmentioning

confidence: 99%

ICU‐free days as a more sensitive primary outcome for clinical trials in critically ill pediatric patients

et al. 2021

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Background Our objective was to assess the association between intensive care unit (ICU)‐free days and patient outcomes in pediatric prehospital care and to evaluate whether ICU‐free days is a more sensitive outcome measure for emergency medical services research in this population. Methods This study used data from a previous pediatric prehospital trial. The original study enrolled patients ≤12 years of age and compared bag‐valve‐mask‐ventilation (BVM) versus endotracheal intubation (ETI) during prehospital resuscitation. For the current study, we defined ICU‐free days as 30 minus the number of days in the ICU (range, 0–30 days) and assigned 0 ICU‐free days for death within 30 days. We compared ICU‐free days between the original study treatment groups (BVM vs ETI) and with the original trial outcomes of survival to hospital discharge and Pediatric Cerebral Performance Category (PCPC). Results Median ICU‐free days for the BVM group (n = 404) versus ETI group (n = 416) was not statistically different: 0 ICU‐free days (interquartile range, 0–10) versus 0 (0–0), P = 0.219. Median ICU‐free days were greater for BVM group in 3 subgroups: foreign body aspiration 30 (0–30) versus 0 (0–21), P = 0.028; child maltreatment 0 (0–14.2) versus 0 (0‐0), P = 0.004; and respiratory arrest 25 (1–29) versus 7.5 (0–27.7), P = 0.015. In the original trial, neither survival nor PCPC demonstrated differences in all 3 subgroups—survival was greater with BVM for child maltreatment and respiratory arrest and favorable PCPC was greater with BVM for foreign body aspiration. Overall, in the current study, patients with more ICU‐free days also had greater survival to hospital discharge and more favorable PCPC scores. Conclusions This initial study of the association between ICU‐free days and patient outcomes during prehospital pediatric resuscitation appears to support the use of ICU‐free days as a clinical endpoint in this population. ICU‐free days may be more sensitive than either mortality or PCPC alone while capturing aspects of both measures.

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Major determinants of survival and length of stay in the neonatal intensive care unit of newborns from women with premature preterm rupture of membranes

Abstract: Prematurity-related complications are the most important problems for which precautions should be taken. Therefore, premature deliveries should be avoided to prevent infection and to prolong the latent period in cases of PPROM in order to decrease prematurity-related outcomes.

Cited by 23 publications

References 20 publications

Risk factors for length of NICU stay of newborns: A systematic review

Risk factors for length of NICU stay of newborns: A systematic review

Antenatal Steroid in Preterm Infants with Respiratory Distress Syndrome

ICU‐free days as a more sensitive primary outcome for clinical trials in critically ill pediatric patients

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