Reporting Outcomes of Extremely Preterm Births

Abstract

Published reports of extremely preterm birth outcomes provide important information to families, clinicians, and others and are widely used to make clinical and policy decisions. Misreporting or misunderstanding of outcome reports may have significant consequences. This article presents 7 recommendations to improve reporting of extremely preterm birth outcomes in both the primary and secondary literature. The recommendations should facilitate clarity in communication about extremely preterm birth outcomes and increase the value of existing and future work in this area.

Association Between Year of Birth and 1-Year Survival Among Extremely Preterm Infants in Sweden During 2004-2007 and 2014-2016

“…Both cohorts fulfilled international recommendations on reporting outcomes for extremely preterm births. 36…”

Survival of Infants Born at Periviable Gestational Ages

“…28 Recommendations to improve reporting of birth outcomes have recently been published with the goal of providing more clinically meaningful and comparable estimates of survival. 29 These recommendations emphasize the importance of reporting standardized information on the source population and outcomes measured, including the timing of assessment, and measures of statistical uncertainty, such as 95% confidence intervals (CI), when reporting on periviable birth outcomes. With the aforementioned caveats that studies have varied in their methodology and reporting, estimates of gestational age-specific survival for select population-based and multicenter studies that report outcomes among periviable live births or infants admitted to the NICU (Table 1) are shown in Figure 2.…”

“…The appropriate numerator and denominator depend on the relevant period at risk. 29 For a woman pregnant with a fetus alive at 20 weeks’ of gestation, studies reporting outcomes with a denominator of infants admitted to the NICU do not reflect all of the potential birth outcomes of her fetus (Figure 3). Likewise, a high stillbirth rate may be obscured by reporting outcomes only among live births, and a high delivery room death rate could be obscured by reporting only outcomes for infants admitted to the NICU (Figure 4).…”

“…37 Therefore, recent recommendations emphasize the importance of stratifying outcomes by those infants that do and do not receive active treatment. 29 …”

Identifying the true scale of perinatal deaths

“…sheds light on hidden and unknown perinatal deaths. In 2016, an expert panel published recommendations for future publications on how to improve reporting of survival after preterm birth and communicate outcomes more clearly . Please follow them!…”