Association between perinatal interventional activity and 2-year outcome of Swiss extremely preterm born infants: a population-based cohort study.

Détails

Ressource 1Télécharger: 30878980_BIB_B2365355C478.pdf (411.79 [Ko])
Etat: Public
Version: Final published version
Licence: CC BY-NC 4.0
ID Serval
serval:BIB_B2365355C478
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Association between perinatal interventional activity and 2-year outcome of Swiss extremely preterm born infants: a population-based cohort study.
Périodique
BMJ open
Auteur(s)
Adams M., Berger T.M., Borradori-Tolsa C., Bickle-Graz M., Grunt S., Gerull R., Bassler D., Natalucci G.
Collaborateur(s)
Swiss Neonatal Network & Follow-Up Group
Contributeur(s)
Anderegg M.C., Mori A.C., Kaeppeli D., Schulzke S., Weber P., Ramelli G.P., Simonetti B.G., Nelle M., Wagner B., Steinlin M., Grunt S., Gebauer M., Hassink R., Bär W., Keller E., Killer C., Fuhrer K., Pfister R.E., Hüppi P.S., Borradori-Tolsa C., Tolsa J.F., Roth-Kleiner M., Bickle-Graz M., Berger T.M., Schmitt-Mechelke T., Bauder F., Pezzoli V., Erkert B., Mueller A., Ecoffey M., Malzacher A., Micallef J.P., Lang-Dullenkopf A., Hegi L., Rhein M.V., Bassler D., Arlettaz R., Bernet V., Latal B., Natalucci G., Moenkhoff M.
ISSN
2044-6055 (Electronic)
ISSN-L
2044-6055
Statut éditorial
Publié
Date de publication
15/03/2019
Peer-reviewed
Oui
Volume
9
Numéro
3
Pages
e024560
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: epublish
Résumé
To investigate if centre-specific levels of perinatal interventional activity were associated with neonatal and neurodevelopmental outcome at 2 years of age in two separately analysed cohorts of infants: cohort A born at 22-25 and cohort B born at 26-27 gestational weeks, respectively.
Geographically defined, retrospective cohort study.
All nine level III perinatal centres (neonatal intensive care units and affiliated obstetrical services) in Switzerland.
All live-born infants in Switzerland in 2006-2013 below 28 gestational weeks, excluding infants with major congenital malformation.
Outcomes at 2 years corrected for prematurity were mortality, survival with any major neonatal morbidity and with severe-to-moderate neurodevelopmental impairment (NDI).
Cohort A associated birth in a centre with high perinatal activity with low mortality adjusted OR (aOR 0.22; 95% CI 0.16 to 0.32), while no association was observed with survival with major morbidity (aOR 0.74; 95% CI 0.46 to 1.19) and with NDI (aOR 0.97; 95% CI 0.46 to 2.02). Median age at death (8 vs 4 days) and length of stay (100 vs 73 days) were higher in high than in low activity centres. The results for cohort B mirrored those for cohort A.
Centres with high perinatal activity in Switzerland have a significantly lower risk for mortality while having comparable outcomes among survivors. This confirms the results of other studies but in a geographically defined area applying a more restrictive approach to initiation of perinatal intensive care than previous studies. The study adds that infants up to 28 weeks benefited from a higher perinatal activity and why further research is required to better estimate the added burden on children who ultimately do not survive.
Mots-clé
Child, Preschool, Developmental Disabilities/epidemiology, Female, Gestational Age, Humans, Infant, Infant Mortality, Infant, Extremely Premature, Infant, Newborn, Intensive Care Units, Neonatal/standards, Length of Stay/statistics & numerical data, Male, Perinatal Care/standards, Retrospective Studies, Switzerland/epidemiology, fetal medicine, neonatology, quality in health care
Pubmed
Web of science
Open Access
Oui
Création de la notice
10/04/2019 16:36
Dernière modification de la notice
05/04/2020 5:20
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