The Mortality of Periviable and Extremely Premature Infants and Their Impact on the Overall Neonatal Mortality Rate

Falciglia, Horacio S.; Merkel, Ronald; Glover, Vickie; Hasselfeld, Kimberly A.; Brady, William

doi:10.1038/s41598-020-59566-3

Cited by 8 publications

(11 citation statements)

References 30 publications

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“…In recent years, researchers have become increasingly interested in the care of periviable infants [ 1 , 2 , 3 ]. The care of periviable infants continues to challenge state-of-the-art medicine.…”

Section: Introductionmentioning

confidence: 99%

Improved Survival of Periviable Infants after Alteration of the Threshold of Viability by the Neonatal Resuscitation Program 2015

Chen

et al. 2021

Children

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Periviable infants (PIs) born at 22–25 weeks gestational age (wGA) have a variable survival rate (49.7–86.2%) among hospitals. One factor involved in this difference may be the definition of the threshold of viability. The American Academy of Pediatrics revised the neonatal resuscitation program in late 2015 (NRP 2015) and altered the threshold of viability from 23 to 22 wGA. The impact on the survival of PIs after the guideline alteration has seldom been discussed. Since 2016, the unit of this study has implemented the renewed guideline for PIs. We retrospectively reviewed and analyzed the survival and clinical variables of PIs before and after implementation of the guideline, which included a 10-year cohort in a single center in Taiwan. There were 168 PIs enrolled between 2010 and 2019 (Epoch-I, 2010–2015; Epoch-II, 2016–2019), after excluding those with congenital anomalies and parent-decided comfort care. Compared to those in Epoch-I, the PIs in Epoch-II had significantly higher odds ratios (2.602) (95% confidence interval: 1.170–5.789; p = 0.019) for survival. Younger gestational age, small size for gestational age, cesarean delivery, low blood pH at birth, and surfactant therapeutic treatment were found to be significant risk factors associated with the survival of PIs (p < 0.05 for each). The altered threshold of viability by NRP 2015 may impact the survival of PIs. However, long-term follow-up for surviving PI is required in the future.

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Section: Introductionmentioning

confidence: 99%

Improved Survival of Periviable Infants after Alteration of the Threshold of Viability by the Neonatal Resuscitation Program 2015

Chen

et al. 2021

Children

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“…It plays an important role in ensuring sustainable development, i.e. the health of the next generation (Falciglia et al, 2020;Robinson, 2004). The health of mothers is extremely important in the health of the next generation.…”

Section: Nosogeographic Situation In the Republic Of Uzbekistanmentioning

confidence: 99%

Ecological situation: the role of education and spirituality in improving health of population

Komilova

Rakhimova

Allaberdiev

et al. 2021

ijhs

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Human health is one of the most important issues for every period of society’s development. After all, the state of development of any country is determined by the level of health and literacy of the population living in the region. The article highlights the ecological situation, the role of knowledge and spirituality in strengthening the health of the population in Uzbekistan, the achievements of medicine, ecology, socio-demographic development in the country during the years of independence data on the reduction of infant and maternal mortality in the age group of the population are also presented. It is known that in more than a quarter of a century (1991-2019), the total mortality rate in the country's population decreased by 1.2% or decreased from 6.2 per thousand to 4.9 per thousand. However, there are still areas with high mortality rates (in Tashkent, Tashkent, and Andijan regions), which can be explained by their location at the transport hub and industrialization. The study and analysis of their regional aspects are some of the important aspects of geographical research. The article also focuses on the issues related to climate change and their impact on the nosoecological situation.

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“…For preterm infants, breastfeeding can not only meet their growth and development needs but also play a therapeutic role [ 14 ]. Breastfeeding can effectively prevent necrotizing enterocolitis in newborns [ 3 ], ROP (retinopathy of prematurity) and other serious complications [ 3 , 4 ] and can reduce the mortality of premature infants [ 15 ]. Breastfeeding failure will lead to the low immunity and a higher incidence rate of chronic diseases in premature infants, which will trigger the short-term and long-term health problems of premature infants [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Factors associated with post NICU discharge exclusive breastfeeding rate and duration amongst first time mothers of preterm infants in Shanghai: a longitudinal cohort study

Jiang

2022

Int Breastfeed J

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Background Breastfeeding is crucial for the preterm infants. Breast milk is not only food but also medicine. Few studies have focused on the longitudinal effects of exclusive breastfeeding outcome of preterm infants separated from their mothers after discharge, especially in Shanghai. We aimed to examine the exclusive breastfeeding rate and duration amongst first time mothers of preterm infants after discharge and its determinants. Methods Analyses were based on 500 preterm infants separated from their mothers in a tertiary maternity and infant-specialized hospital in Shanghai from September 2018 to September 2019.The Socio-demographic characteristics, breastfeeding knowledge questionnaire, breastfeeding self-efficacy short form scale, Edinburgh postpartum depression scale and breastfeeding family support scale were used for the investigation and the exclusive breastfeeding rate of premature infants was followed up on 1 month, 3 months and 6 months after discharge. The changing trend of breastfeeding knowledge, breastfeeding self-efficacy, postpartum depression and family support were measured by ANOVA at different stages. Using the chi-square test and multiple logistic regression, factors impacting the breastfeeding rate of preterm infants at three time intervals after discharge were investigated. The Kaplan Meier survival curve and cox regression model were used to analyze the determinants of exclusive breastfeeding duration of premature infants after discharge. Results Exclusive breastfeeding rates were 19.0, 17.2 and 10.4% at 1 month, 3 months and 6 months after discharge of preterm infants, respectively. The average length of exclusive breastfeeding duration was(3.69 ± 1.80)months. Finally, type of delivery (adjusted odds ratio [AOR] 1.564; 95% confidence interval [CI] 0.513,3.116), gestational age(AOR 0.612, 95% CI 0.236, 3.418), maternal family support (AOR 6.125,95% CI 6.359, 98.452) were discovered to be independent predictors on the exclusive breastfeeding rate at 6 months after preterm infants were discharged. Through the cox regression model, we found that a maternal planned pregnancy (HR 0.681, 95%CI 0.531,0.873), delivering breast milk during hospitalization (HR 0.797, 95%CI 0.412,2.288), NICU feeding mode during hospitalization (HR 1.221, 95%CI 0.128,1.381) and family support (HR 0.561, 95%CI 0.004,2.428) were significantly associated with the exclusive breastfeeding duration after discharge. Conclusions The exclusive breastfeeding outcome of premature infants was affected by many factors, so we should focus on the three levels of individual, family, society and design targeted intervention measures to increase the exclusive breastfeeding rate and prolong exclusive breastfeeding duration.

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The Mortality of Periviable and Extremely Premature Infants and Their Impact on the Overall Neonatal Mortality Rate

Cited by 8 publications

References 30 publications

Improved Survival of Periviable Infants after Alteration of the Threshold of Viability by the Neonatal Resuscitation Program 2015

Improved Survival of Periviable Infants after Alteration of the Threshold of Viability by the Neonatal Resuscitation Program 2015

Ecological situation: the role of education and spirituality in improving health of population

Factors associated with post NICU discharge exclusive breastfeeding rate and duration amongst first time mothers of preterm infants in Shanghai: a longitudinal cohort study

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