Outcome of outborn infants at the borderline of viability in Western Australia: A retrospective cohort study

Thompson, Kirsten; Gardiner, Jacqueline; Resnick, Steven D.

doi:10.1111/jpc.13187

Cited by 17 publications

(23 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, of the 9 countries with outborn rates available, 7 reported a decrease in outborn neonates in epoch 2, which previous reports showed was associated with decreased mortality. [28][29][30] However, the observed practice changes only partly explains the differences in outcomes rates between and within countries. Socioeconomic circumstances among countries may differ and external economic impacts on national scales also may have contributed to the changes in services available and outcome changes observed.…”

Section: Discussionmentioning

confidence: 99%

Trends in Outcomes for Neonates Born Very Preterm and Very Low Birth Weight in 11 High-Income Countries

Lui

Lee

Kusuda

et al. 2019

The Journal of Pediatrics

186

132

View full text Add to dashboard Cite

on behalf of the International Network for Evaluation of Outcomes (iNeo) of neonates Investigators* Objective To evaluate outcome trends of neonates born very preterm in 11 high-income countries participating in the International Network for Evaluating Outcomes of neonates. Study design In a retrospective cohort study, we included 154 233 neonates admitted to 529 neonatal units between January 1, 2007, and December 31, 2015, at 24 0/7 to 31 6/7 weeks of gestational age and birth weight <1500 g. Composite outcomes were in-hospital mortality or any of severe neurologic injury, treated retinopathy of prematurity, and bronchopulmonary dysplasia (BPD); and same composite outcome excluding BPD. Secondary outcomes were mortality and individual morbidities. For each country, annual outcome trends and adjusted relative risks comparing epoch 2 (2012-2015) to epoch 1 (2007-2011) were analyzed. Results For composite outcome including BPD, the trend decreased in Canada and Israel but increased in Australia and New Zealand, Japan, Spain, Sweden, and the United Kingdom. For composite outcome excluding BPD, the trend decreased in all countries except Spain, Sweden, Tuscany, and the United Kingdom. The risk of composite outcome was lower in epoch 2 than epoch 1 in Canada (adjusted relative risks 0.78; 95% CI 0.74-0.82) only. The risk of composite outcome excluding BPD was significantly lower in epoch 2 compared with epoch 1 in Australia and New Zealand, Canada, Finland, Japan, and Switzerland. Mortality rates reduced in most countries in epoch 2. BPD rates increased significantly in all countries except Canada, Israel, Finland, and Tuscany. Conclusions In most countries, mortality decreased whereas BPD increased for neonates born very preterm.

show abstract

Section: Discussionmentioning

confidence: 99%

Trends in Outcomes for Neonates Born Very Preterm and Very Low Birth Weight in 11 High-Income Countries

Lui

Lee

Kusuda

et al. 2019

The Journal of Pediatrics

186

132

View full text Add to dashboard Cite

show abstract

“…The findings in our study are consistent with research by Killion and Stein, where retrieval by air was 25% faster than road retrievals from the same location – however, this did not change outcomes – and also by Thompson et al ., who showed similar outcomes in infants retrieved by road from close locations compared with air retrievals from more distant locations …”

Section: Discussionmentioning

confidence: 79%

“…Thompson et al . noted no difference in mortality rates between infants transported by road over shorter distances and infants transported longer distances via air in a population of infants less than 26 weeks gestation . Lui et al .…”

mentioning

confidence: 94%

Does earlier arrival of the retrieval team improve short‐term outcomes in outborn extremely premature infants?

Sharpe

Davies

2018

J Paediatrics Child Health

View full text Add to dashboard Cite

show abstract

“…Population-based studies in the USA demonstrate increased mortality among these ‘outborn’ neonates,3–6 with odds of death approximately 55% higher than ‘inborn’ neonates 7. Similar survival disparities have been described in other developed nations,8–15 where outborn status also predicts worse long-term neurodevelopment 9 10. Despite regionalisation of perinatal care in these countries,1 2 approximately 15% of very preterm neonates are outborn6 11 12—perhaps 10 000 neonates each year in USA alone 16…”

Section: Introductionmentioning

confidence: 74%

“…Perinatal characteristics, including maternal comorbid illnesses, complications of pregnancy, precipitous and spontaneous preterm labour and exposure to antenatal steroids, are significantly different between inborn and outborn preterm neonates 5 10–12 14 17. Study design must be sufficient to discern the impact of inborn-outborn status from other potential confounders when analysing patient outcomes.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of outborn extremely preterm neonates admitted to a NICU with respiratory distress

Fang

Mara

Weaver

et al. 2019

Arch Dis Child Fetal Neonatal Ed

View full text Add to dashboard Cite

ObjectiveTo compare the risk of mortality and morbidity between outborn and propensity score-matched inborn extremely preterm neonates.SettingMultiple neonatal intensive care units (NICU) across the USA.PatientsSingleton neonates born at 22–29 weeks’ gestation with no major anomalies who were admitted to an NICU and discharged between 2000 and 2014. Outborn neonates were restricted to those who transferred into an NICU on the day of birth.MethodsThe association between inborn-outborn status and the time-to-event outcomes of in-hospital mortality and necrotising enterocolitis (NEC) were assessed using Cox proportional hazards regression. Logistic regression was used to assess the remaining secondary outcomes: retinopathy of prematurity requiring treatment (tROP), chronic lung disease (CLD), periventricular leucomalacia (PVL) and severe intraventricular haemorrhage (IVH). Since outborn status was not random, we used 1:1 propensity score matching to reduce the imbalance in illness severity.ResultsThere were 59 942 neonates (7991 outborn) included in the study. Outborn neonates had poorer survival than inborns and higher rates of NEC, severe IVH, tROP and PVL. Inborn-outborn disparities in mortality were reduced over the study period. When analysing the matched cohort (6524 matched pairs), outborns were less likely to die in-hospital compared with inborns (HR 0.84, 95% CI 0.77 to 0.91). However, outborns experienced higher rates of NEC (HR 1.14, 95% CI 1.04 to 1.25), severe IVH (OR 1.52, 95% CI 1.38 to 1.68), tROP (OR 1.45, 95% CI 1.25 to 1.69) and CLD (OR 1.12, 95% CI 1.01 to 1.24).ConclusionAdditional research is needed to understand the contributors to increased morbidity for outborn extremely preterm neonates and identify interventions that mitigate this risk.

show abstract

Outcome of outborn infants at the borderline of viability in Western Australia: A retrospective cohort study

Abstract: Outborn extremely preterm infants <26 weeks gestation have higher mortality than inborn counterparts. However, those transported to a tertiary NICU have similar morbidity and developmental outcomes.

Cited by 17 publications

References 36 publications

Trends in Outcomes for Neonates Born Very Preterm and Very Low Birth Weight in 11 High-Income Countries

Trends in Outcomes for Neonates Born Very Preterm and Very Low Birth Weight in 11 High-Income Countries

Does earlier arrival of the retrieval team improve short‐term outcomes in outborn extremely premature infants?

Outcomes of outborn extremely preterm neonates admitted to a NICU with respiratory distress

Contact Info

Product

Resources

About