Mortality Rates for Extremely Low Birth Weight Infants Born in Japan in 2005

Itabashi, Kazuo; Horiuchi, Takeshi; Kusuda, Satoshi; Kabe, Kazuhiko; Itani, Yoshio; Nakamura, Takashi; Fujimura, Masanori; Matsuo, Masafumi

doi:10.1542/peds.2008-0763

Cited by 210 publications

(220 citation statements)

References 14 publications

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“…5,7,10,11,14,[16][17][18]20,36,37,47 Other studies include only infants admitted to the NICU, with survival rates ranging from 0% to 66%. 4,9,[11][12][13][14][15]17,18,20,21,23,24,34 Previous Canadian studies that did not include stillbirth noted survival rates in infants admitted to the NICU of 35.2% to 41.7%. 4,15,24 The survival rate was lower in our study.…”

Section: Discussionmentioning

confidence: 99%

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Maternal and Perinatal Outcomes of Pregnancies Delivered at 23 Weeks’ Gestation

Crane

Magee

Lee

et al. 2015

Journal of Obstetrics and Gynaecology Canada

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Objective: To evaluate the maternal and perinatal outcomes of pregnancies delivered at 23+0 to 23+6 weeks' gestation .Methods: This prospective cohort study included women in the Canadian Perinatal Network who were admitted to one of 16 Canadian tertiary perinatal units between August 1, 2005, and March 31, 2011, and who delivered at 23+0 to 23+6 weeks' gestation . Women were included in the network if they were admitted with spontaneous preterm labour with contractions, a short cervix without contractions, prolapsing membranes with membranes at or beyond the external os or a dilated cervix, preterm premature rupture of membranes, intrauterine growth restriction, gestational hypertension, or antepartum hemorrhage . Maternal outcomes included Caesarean section, placental abruption, and serious complication . Perinatal outcomes were mortality and serious morbidity .Results: A total of 248 women and 287 infants were included in the study . The rate of Caesarean section was 10 .5% (26/248) and 40 .3% of women (100/248) had a serious complication, the most common being chorioamnionitis (38 .6%), followed by blood transfusion (4 .5% (25/25) . Two subgroup analyses were performed: in one, antepartum stillbirths were excluded, and in the other only centres that indicated they offered fetal monitoring at 23 weeks' gestation were included and antepartum stillbirths were excluded . In each of these, perinatal outcomes similar to the overall group were found . Conclusion:Pregnant women delivering at 23 weeks' gestation are at risk of morbidity . Their infants have high rates of serious morbidity and mortality . Further research is needed to identify strategies and forms of management that not only increase perinatal survival but also reduce morbidities in these extremely low gestational age infants and reduce maternal morbidity .

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Section: Discussionmentioning

confidence: 99%

“…29,[40][41][42][43][44] Finally, a number of studies present data from populations that may differ from the Canadian population with respect to ethnicity and access to health care. 3,[7][8][9][10][11][12][13][14][16][17][18][19][20][21][22][23]34,45 Few studies have evaluated maternal outcomes of women delivering at a periviable gestation.…”

Section: Introductionmentioning

confidence: 99%

Maternal and Perinatal Outcomes of Pregnancies Delivered at 23 Weeks’ Gestation

Crane

Magee

Lee

et al. 2015

Journal of Obstetrics and Gynaecology Canada

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“…26,27 Japan has recently reported intact survival rates for infants born alive at 22 weeks of gestation comparable to those born at 23 weeks of gestation, with overall survival rates of 33%. 28 A study in the United States found similar rates of survival among newborn infants born at 22 weeks' gestation. 29 Therefore, if survival were the only consideration, it would seem reasonable to offer resuscitation and intensive care to all infants born at or beyond 22 weeks of gestation.…”

Section: Outcome According To Gestational Agementioning

confidence: 98%

Antenatal Counseling Regarding Resuscitation and Intensive Care Before 25 Weeks of Gestation

Cummings¹,

Watterberg²,

Eichenwald³

et al. 2015

Pediatrics

231

133

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The anticipated birth of an extremely low gestational age (<25 weeks) infant presents many difficult questions, and variations in practice continue to exist. Decisions regarding care of periviable infants should ideally be well informed, ethically sound, consistent within medical teams, and consonant with the parents’ wishes. Each health care institution should consider having policies and procedures for antenatal counseling in these situations. Family counseling may be aided by the use of visual materials, which should take into consideration the intellectual, cultural, and other characteristics of the family members. Although general recommendations can guide practice, each situation is unique; thus, decision-making should be individualized. In most cases, the approach should be shared decision-making with the family, guided by considering both the likelihood of death or morbidity and the parents’ desires for their unborn child. If a decision is made not to resuscitate, providing comfort care, encouraging family bonding, and palliative care support are appropriate.

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“…With the increased survival of extremely preterm infants (<28 weeks of gestation), 1 uncertainty about their neurodevelopmental (ND) outcome has become of paramount concern. Along with intraventricular hemorrhage (IVH), cerebellar hemorrhage (CH) may represent a major risk factor for ND problems in these preterm infants.…”

Section: Introductionmentioning

confidence: 99%

Cerebellar hemorrhage: a major morbidity in extremely preterm infants

et al. 2011

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Objective: To determine the impact of cerebellar hemorrhage (CH) on mortality and adverse neurodevelopmental (ND) outcome rates in extremely preterm infants admitted to a tertiary neonatal unit.Study Design: A total of 1120 eligible infants (<28 weeks gestation) were born from 1998 to 2008 and had at least one cranial ultrasound. ND outcome was determined at 12 to 18 months corrected age.Results: Most CH (75%) occurred in infants <25 weeks gestation. CH did not affect mortality rates, however, it was associated with both mental and motor impairments, with incidence rate ratios of 3.08 (1.71 to 4.84) and 2.12 (1.12 to 3.45), respectively. Moreover, the risk of cerebral palsy (CP) was increased in infants with CH involving the medial part of the cerebellum. Conclusion:Our findings substantiate recent reports about the cerebellum, highlighting its role in cognitive and executive functions, and associating early cerebellar injury not only with CP but also with learning, affective and behavioral disorders.

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Mortality Rates for Extremely Low Birth Weight Infants Born in Japan in 2005

Abstract: The mortality rates of extremely low birth weight infants who were born in 2005 demonstrated definite improvement.

Cited by 210 publications

References 14 publications

Maternal and Perinatal Outcomes of Pregnancies Delivered at 23 Weeks’ Gestation

Maternal and Perinatal Outcomes of Pregnancies Delivered at 23 Weeks’ Gestation

Antenatal Counseling Regarding Resuscitation and Intensive Care Before 25 Weeks of Gestation

Cerebellar hemorrhage: a major morbidity in extremely preterm infants

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