Short-term outcomes of extremely preterm infants at discharge: a multicenter study from Guangdong province during 2008–2017

Wu, Fan; Liu, Guosheng; Feng, Zhoushan; Tan, Xiaohua; Yang, Chuanzhong; Ye, Xiaotong; Dai, Yiheng; Liang, Wei; Ye, Xiuzhen; Mo, Jing; Ding, Lu; Wu, Benqing; Chen, Hong-Xiang; Li, Chi-Wang; Zhang, Zhe; Xiao, Rong; Shen, Wei; Huang, Weimin; Yang, Bing-Yan; Lv, Jun-Feng; Huo, Le-Ying; Huang, Huiwen; Rao, Hongping; Wang, Yan; Yong, Yang; Ren, Xuejun; Wang, Fangfang; Liu, Dong; Diao, Shi-Guang; Liu, Xiaoyan; Meng, Qiong; Wang, Yu; Wang, Bin; Zhang, Lijuan; Huang, Yuge; Ao, Dang; Li, Weizhong; Chen, Jieling; Chen, Yanling; Li, Wei; Chen, Zhifeng; Ding, Yueqin; Li, Xiaoyü; Huang, Yuefang; Lin, Ning; Cai, Yangfan; Han, Shasha; Jin, Yifeng; Wan, Zhong-He; Ban, Yi; Bai, Bo; Li, Guanghong; Yan, Yue-Xiu; Cui, Qiliang

doi:10.1186/s12887-019-1736-8

Cited by 41 publications

(51 citation statements)

References 26 publications

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“…Our study demonstrated the prevalences, perinatal and neonatal morbidity and mortality by GA strata of total preterm births or hospitalized preterm infants, from a complete birth population in an emerging region of China. These findings should be complementary to the findings from reports of national surveys by sampling, or institution-based studies on perinatal and neonatal outcome in China, which lacked comprehensive perinatal data from the regional birth-population perspective [ 42 – 45 ]. As a result, we speculate that our understanding on the preterm birth status in China, either nation-wide or province-wide, would have substantial negligence, error and bias in terms of source and representativeness of data and database.…”

Section: Discussionmentioning

confidence: 64%

A birth population-based survey of preterm morbidity and mortality by gestational age

Guo

et al. 2021

BMC Pregnancy Childbirth

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Background Despite 15–17 millions of annual births in China, there is a paucity of information on prevalence and outcome of preterm birth. We characterized the outcome of preterm births and hospitalized preterm infants by gestational age (GA) in Huai’an in 2015, an emerging prefectural region of China. Methods Of 59,245 regional total births, clinical data on 2651 preterm births and 1941 hospitalized preterm neonates were extracted from Huai’an Women and Children’s Hospital (HWCH) and non-HWCH hospitals in 2018–2020. Preterm prevalence, morbidity and mortality rates were characterized and compared by hospital categories and GA spectra. Death risks of preterm births and hospitalized preterm infants in the whole region were analyzed with multivariable Poisson regression. Results The prevalence of extreme, very, moderate, late and total preterm of the regional total births were 0.14, 0.53, 0.72, 3.08 and 4.47%, with GA-specific neonatal mortality rates being 44.4, 15.8, 3.7, 1.5 and 4.3%, respectively. There were 1025 (52.8% of whole region) preterm admissions in HWCH, with significantly lower in-hospital death rate of inborn (33 of 802, 4.1%) than out-born (23 of 223, 10.3%) infants. Compared to non-HWCH, three-fold more neonates in HWCH were under critical care with higher death rate, including most extremely preterm infants. Significantly all-death risks were found for the total preterm births in birth weight < 1000 g, GA < 32 weeks, amniotic fluid contamination, Apgar-5 min < 7, and birth defects. For the hospitalized preterm infants, significantly in-hospital death risks were found in out-born of HWCH, GA < 32 weeks, birth weight < 1000 g, Apgar-5 min < 7, birth defects, respiratory distress syndrome, necrotizing enterocolitis and ventilation, whereas born in HWCH, antenatal glucocorticoids, cesarean delivery and surfactant use decreased the death risks. Conclusions The integrated data revealed the prevalence, GA-specific morbidity and mortality rate of total preterm births and their hospitalization, demonstrating the efficiency of leading referral center and whole regional perinatal-neonatal network in China. The concept and protocol should be validated in further studies for prevention of preterm birth.

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Section: Discussionmentioning

confidence: 64%

A birth population-based survey of preterm morbidity and mortality by gestational age

Guo

et al. 2021

BMC Pregnancy Childbirth

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“…14 , 15 , 16 With advances in perinatal and neonatal care, more and more infants have been born at earlier GA and survived. 17 Understanding the characteristics and outcomes of infants born extremely preterm is essential for parent counseling, medical decision making, clinical management, and policy making. This study primarily aimed to evaluate mortality and major morbidity among infants born extremely preterm in China over the past decade.…”

Section: Introductionmentioning

confidence: 99%

Mortality and Morbidity of Infants Born Extremely Preterm at Tertiary Medical Centers in China From 2010 to 2019

et al. 2021

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“…Second, parents may be concerned about the longterm prognosis of their infants. Previous authors reported that infants who were DAMA account for 53-92% of VPI deaths in Chinese NICUs and concern for long term adverse outcomes was the most common reason given for the decision to DAMA (13,(26)(27)(28)(29)(30)(31)(32). Finally, a lack of appropriate prenatal and postnatal counselling might also contribute to DAMA.…”

Section: Discussionmentioning

confidence: 99%

Outcome of very preterm infants delivered outside tertiary perinatal centers in China: a multi-center cohort study

et al. 2021

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Background: To describe the incidence of outborns among very preterm infants (VPIs, <32 weeks of gestation) in Chinese perinatal centers and to examine the association of outborn status with adverse outcomes.Methods: A cohort study enrolling all VPIs admitted to 18 perinatal centers in China from May 1st, 2015 to April 30th, 2018. Neonatal outcomes including rates of discharge against medical advice (DAMA), in-hospital mortality, overall mortality, severe intraventricular hemorrhage (IVH) or periventricular leukomalacia (PVL), sepsis, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC) and severe retinopathy of prematurity (ROP) were compared between outborn and inborn infants. A multivariate logistic regression model was used to estimate the independent association of outborn status with neonatal outcomes.Results: Among 12,014 VPIs, 1,991 (16.6%) infants were outborn. Outborn infants had lower Apgar scores and higher illness severity score on admission. Mothers of outborn infants were less likely to receive antenatal steroids, prenatal care and caesarean section. The incidence of DAMA (18.0% vs. 12.5%, P<0.001), overall mortality (19.9% vs. 15.8%, P<0.001) and severe brain injury (10.8% vs. 9.1%, P=0.024) of outborn infants were significantly higher than inborn infants. Outborn status was independently associated with

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Short-term outcomes of extremely preterm infants at discharge: a multicenter study from Guangdong province during 2008–2017

Cited by 41 publications

References 26 publications

A birth population-based survey of preterm morbidity and mortality by gestational age

A birth population-based survey of preterm morbidity and mortality by gestational age

Mortality and Morbidity of Infants Born Extremely Preterm at Tertiary Medical Centers in China From 2010 to 2019

Outcome of very preterm infants delivered outside tertiary perinatal centers in China: a multi-center cohort study

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