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

Norman, M; Hallberg, Boubou; Abrahamsson, Thomas; Björklund, Lars; Domellöf, Magnus; Farooqi, Aijaz; Bruun, Cathrine Foyn; Gadsbøll, Christian; Hellström‐Westas, Lena; Ingemansson, Fredrik; Källén, Kristina; Ley, David; Maršál, Karel; Normann, Erik; Serenius, Fredrik; Stephansson, O.; Stigson, Lennart; Um-Bergström, Petra; Håkansson, Stellan

doi:10.1097/01.aoa.0000652812.23211.7b

Cited by 3 publications

(3 citation statements)

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“…18,19 A Swedish national population-based cohort study 2014-2016 showed an unprecedented high survival (77%) of extremely preterm infants born between 22 and 26 weeks of gestation. 20 One contributing factor to severe morbidity is the chronic lung disease, BPD, which is also a predictor of adverse long-term outcome.…”

Section: Discussionmentioning

confidence: 99%

Neonatal clinical blood sampling led to major blood loss and was associated with bronchopulmonary dysplasia

et al. 2019

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Aim Studies indicate that reduced foetal haemoglobin levels are related to increased neonatal morbidity rates. This study investigated the relationships between sampling‐related blood loss and adult blood transfusions administered during postnatal days 1‐14 and the development of severe neonatal morbidities in extremely preterm infants born before 28 weeks of gestation. Methods The medical files of 149 extremely preterm infants born at two university hospitals in Sweden from 2013 to 2018 were investigated. Results Blood sampling resulted in a 58% depletion of the endogenous blood volume postnatal days 1‐14 (median 40.4 mL/kg, interquartile range 23.9‐53.3 mL/kg) and correlated with the adult erythrocyte transfusion volume (rS = 0.870, P < .001). Sampling‐related blood loss on postnatal days 1‐7, adjusted for gestational age at birth and birth weight standard deviation score, was associated with the development of bronchopulmonary dysplasia (BPD) (odds ratio by a 10‐unit increase 2.4, 95% confidence interval 1.1‐5.4) (P = .03). No associations were found between blood sampling and intraventricular haemorrhage or necrotising enterocolitis in the full statistical model. The largest proportion of sampling‐related blood was used for blood gas analyses (48.7%). Conclusion Diagnostic blood sampling led to major endogenous blood loss replaced with adult blood components and was associated with the development of BPD.

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Section: Discussionmentioning

confidence: 99%

Neonatal clinical blood sampling led to major blood loss and was associated with bronchopulmonary dysplasia

et al. 2019

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“…During the past decade, neonatal care has continuously improved, resulting in more and more immature babies born and surviving (Norman, Hallberg, et al, 2019). This development has led to an increased proportion of extremely preterm children with a high risk of severe retinopathy of prematurity (ROP) requiring treatment.…”

Section: Introductionmentioning

confidence: 99%

Treatment for retinopathy of prematurity in Sweden 2008–2021: Reduced gestational age of treated infants and remaining differences in treatment type and recurrence rates between hospitals

Holmström,

Hellström,

Teär Fahnehjelm

et al. 2023

Acta Ophthalmologica

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PurposeThis study aimed to investigate various aspects of treatment for retinopathy of prematurity (ROP) in Sweden over the past 14 years, nationally and at a hospital level.MethodsData on screening and treatment for ROP in infants born in Sweden from 2008 to 2021 were extracted from the national ROP register, SWEDROP. During this period, Swedish screening guidelines were reduced from gestational age (GA) < 32 weeks to <31 weeks in 2012 and to <30 weeks in 2020.ResultsAltogether, 10 959 infants were screened and 600 infants treated for ROP during the study period. Parallel to changed guidelines, the number of screened infants decreased (p < 0.000) and the incidence of ROP and frequency of treatment increased (p < 0.001), while both remained similar in infants with a GA below 30 weeks. Among treated infants, GA and BW were reduced over the years (p < 0.001). Laser treatment (85.2% of primary treatments) became less common and anti‐VEGF injections (13.6%) became more common over time (p < 0.001). Altogether 16 eyes were treated with the encircling band and 13 with vitrectomy. The total frequency of retreatment (32.7% of treated eyes) remained similar over time but was more common after primary anti‐VEGF injection (67.7%) than laser treatment (27.2%). There were differences between the seven university hospitals regarding type of treatment and number of retreatments (p < 0.001).ConclusionThe frequency of treatment and retreatment for ROP remained similar over time, but the type of treatment changed and anti‐VEGF injections became more common. Differences between treating hospitals emphasize the importance of centralizing the most severe cases.

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“…Advances in perinatal and neonatal medicine have successively decreased the limit of extrauterine survival, and this has led to the survival of an increasing number of extremely preterm neonates. 1,2 It has been established that determining umbilical cord blood gases at birth is the most objective method of describing the metabolic condition of the term newborn. 3 However, very few studies have addressed the clinical usefulness of cord blood analysis in extremely preterm newborns.…”

Section: Introductionmentioning

confidence: 99%

Hypoxia with acidosis in extremely preterm born infants was not associated with an increased risk of death or impaired neurodevelopmental outcome at 6.5 years

et al. 2019

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Aim It is not clear whether perinatal acidosis can predict poor outcomes in extremely preterm infants and we investigated associations between intrapartum hypoxia and mortality and neurodevelopmental outcomes. Methods We used nationwide data on 705 infants from the Extremely Preterm Infants in Sweden Study, delivered at 22‐26 weeks of gestation during 2004‐2007. Comprehensive neurodevelopmental assessments were performed on survivors at 2.5 (n = 456) and 6.5 (n = 441) years of corrected age. Gestational age‐related changes in umbilical cord arterial pH were compared with reference values for term newborn infants, and base excess was also calculated. Associations between low blood gas values (<10th percentile) and mortality and neurodevelopmental outcome were estimated. Results Cord blood determination was more common in surviving infants (P < .001), with pH determined in 322/705 (46%) and base excess in 311/705 (44%). Extremely preterm infants had higher pH values than term infants (P < .0001), with no change from 22 to 26 weeks of gestation (P = .61, r2 = .001). Multiple logistic regression showed no association between low blood gas values and risk of death or neurodevelopmental impairment at 6.5 years (P ≥ .17). Conclusion Hypoxia with acidosis at birth was not associated with an increased risk of death or impaired neurodevelopmental in extremely preterm born children at 6.5 years.

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

Cited by 3 publications

References 0 publications

Neonatal clinical blood sampling led to major blood loss and was associated with bronchopulmonary dysplasia

Neonatal clinical blood sampling led to major blood loss and was associated with bronchopulmonary dysplasia

Treatment for retinopathy of prematurity in Sweden 2008–2021: Reduced gestational age of treated infants and remaining differences in treatment type and recurrence rates between hospitals

Hypoxia with acidosis in extremely preterm born infants was not associated with an increased risk of death or impaired neurodevelopmental outcome at 6.5 years

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