Variation in term birthweight across European countries affects the prevalence of small for gestational age among very preterm infants

Zeitlin, Jennifer; Bonamy, Anna‐Karin Edstedt; Piedvache, Aurélie; Cuttini, Marina; Barros, Henrique; Reempts, Patrick Van; Mazela, Jan; Jarreau, Pierre‐Henri; Gortner, Ludwig; Draper, Elizabeth S; Maier, Rolf F.

doi:10.1111/apa.13899

Cited by 56 publications

(63 citation statements)

References 30 publications

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“…Basic demographic and clinical data were collected to describe maternal and infant characteristics, including maternal age (mean and percentage of women 35 years and over); parity (primiparous); delivery in a level III maternity unit using national definitions (yes/no); antenatal corticosteroids administration (any/no); whether the delivery occurred on the same day as hospital admission; mode of delivery (cesarean/vaginal delivery); gestational age in completed weeks; small for gestational age, defined as a birth weight for gestational age ≤10th percentile of intrauterine growth curves; infant sex and presence of serious congenital anomalies (defined using Eurocat data as those associated with a high probability of death) …”

Section: Methodsmentioning

confidence: 99%

Characteristics, management and outcomes of very preterm triplets in 19 European regions

Dudenhausen

Misselwitz²,

Piedvache

et al. 2019

Intl J Gynecology & Obste

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Objective To describe obstetrical care and in‐hospital outcomes in very preterm triplet pregnancies in a European multiregional cohort. Methods Data from a prospective population‐based study of very preterm births between 22 + 0 and 31 + 6 weeks of gestation in 19 regions from 11 European countries participating in the EPICE project in 2011/2012 were used to describe triplet pregnancies and compare them with twins and singletons. Results Triplets constituted 1.1% of very preterm pregnancies (97/8851) and 3.3% of very preterm live births (258/7900); these percentages varied from 0% to 2.6% and 0% to 6% respectively across the regions. In‐hospital mortality after live birth was 12.4% and did not differ significantly from singletons or twins or by birth order. However, 28.9% of mothers with a triplet pregnancy experienced at least one neonatal death. Ninety percent of live‐born triplets were delivered by cesarean. Vaginal delivery was associated with an Apgar score of less than 7, but not with in‐hospital mortality. Conclusions The prevalence of very preterm triplets varies across European regions. Most triplets were born by cesarean and those born vaginally had lower Apgar scores. Overall, in‐hospital mortality after live birth was similar to singletons and twins.

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Section: Methodsmentioning

confidence: 99%

Characteristics, management and outcomes of very preterm triplets in 19 European regions

Dudenhausen

Misselwitz²,

Piedvache

et al. 2019

Intl J Gynecology & Obste

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“…Infant characteristics were gestational age, whether the child had a severe neonatal morbidity diagnosed before discharge home—including intraventricular haemorrhage Papille's grades III or IV, cystic periventricular leukomalacia, retinopathy of prematurity III to V, necrotizing enterocolitis, and bronchopulmonary dysplasia (BPD), defined as respiratory support or oxygen at 36 weeks post menstrual age (Bonamy et al, ). We also included information on whether the infant was small for gestational age (<10th percentile) using intrauterine curves (Zeitlin et al, ), had any surgery, or was transferred during neonatal care. Finally for the subset of children who were no longer breastfed after discharge, we created a variable to describe their feeding status at discharge (receiving exclusive breast milk at the breast, exclusive breast milk but not from the breast, mixed feeding (breast milk and formula) with breast milk from the breast, mixed feeding with breast milk not from the breast).…”

Section: Methodsmentioning

confidence: 99%

Low breastfeeding continuation to 6 months for very preterm infants: A European multiregional cohort study

Bonnet

Blondel

Piedvache

et al. 2018

Maternal & Child Nutrition

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Breastfeeding confers multiple benefits for the health and development of very preterm infants, but there is scarce information on the duration of breastfeeding after discharge from the neonatal intensive care unit (NICU). We used data from the Effective Perinatal Intensive Care in Europe population-based cohort of births below 32 weeks of gestation in 11 European countries in 2011-2012 to investigate breastfeeding continuation until 6 months. Clinical and sociodemographic characteristics were collected from obstetric and neonatal medical records as well as parental questionnaires at 2 years of corrected age. Among 3,217 ever-breastfed infants, 34% were breastfeeding at 6 months of age (range across countries from 25% to 56%); younger and less educated mothers were more likely to stop before 6 months (adjusted relative risk [aRR] <25 years: 0.68, 95% CI [0.53, 0.88], vs. 25-34 years; lower secondary: 0.58, 95% CI [0.45, 0.76] vs. postgraduate education). Multiple birth, bronchopulmonary dysplasia (BPD), and several neonatal transfers reduced the probability of continuation but not low gestational age, fetal growth restriction, congenital anomalies, or severe neonatal morbidities. Among infants breastfeeding at discharge, mixed versus exclusive breast milk feeding at discharge was associated with stopping before 6 months: aRR = 0.60, 95% CI [0.48, 0.74]. Low breastfeeding continuation rates in this high-risk population call for more support to breastfeeding mothers during and after the neonatal hospitalization, especially for families with low socio-economic status, multiples, and infants with BPD. Promotion of exclusive breastfeeding in the NICU may constitute a lever for improving breastfeeding continuation after discharge.

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“…Gestational age was the best obstetric estimate based on information on last menstrual period and ultrasound measures. Small for gestational age (SGA) was defined as birth weight <10th percentile using European intrauterine references 20. Severe congenital anomalies were those reported by European Registry of Congenital Anomalies and Twins (EUROCAT) 21.…”

Section: Methodsmentioning

confidence: 99%

Breastfeeding outcomes in European NICUs: impact of parental visiting policies

Cuttini

Croci

Toome

et al. 2018

Arch Dis Child Fetal Neonatal Ed

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Variation in term birthweight across European countries affects the prevalence of small for gestational age among very preterm infants

Abstract: One-third of VPT infants were SGA according to intrauterine references. Common European references showed significant differences in SGA prevalence between countries with high and low-term birthweights.

Cited by 56 publications

References 30 publications

Characteristics, management and outcomes of very preterm triplets in 19 European regions

Characteristics, management and outcomes of very preterm triplets in 19 European regions

Low breastfeeding continuation to 6 months for very preterm infants: A European multiregional cohort study

Breastfeeding outcomes in European NICUs: impact of parental visiting policies

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