Cause-Specific Mortality of Very Preterm Infants and Antenatal Events - 23/05/13
Reprint requests: Marina Cuttini, MD, Unit of Epidemiology, Bambino Gesù Children’s Hospital, Piazza S. Onofrio 4, 00165 Roma, Italy.Abstract |
Objective |
To assess the relationship between antenatal factors and cause-specific risk of death in a large area-based cohort of very preterm infants.
Study design |
The ACTION (Accesso alle Cure e Terapie Intensive Ostetriche e Neonatali) study recruited during an 18-month period all infants 22-31 weeks’ gestational age admitted to neonatal care in 6 Italian regions (n = 3040). We analyzed the data of 2974 babies without lethal or acutely life-threatening malformations. Cause-specific risks of death adjusted for competing causes were calculated, and region-stratified multiple Cox regression analyses were used to study the association between cause-specific mortality and infants’ characteristics, pregnancy complications, antenatal steroids, and place of birth.
Results |
Deaths attributable to respiratory problems and intraventricular hemorrhage prevailed in the first 2 weeks of life, and those attributable to infections and gastrointestinal diseases afterwards. Antepartum hemorrhage was associated with respiratory deaths (hazard ratio [HR] 1.6, 95% CI 1.1-2.4), and maternal infection with deaths attributable to asphyxia (HR 32.5, 95% CI 4.1-259.4) and to respiratory problems (HR 2.8, 95% CI 1.6-5.2). Preterm premature rupture of membranes increased the likelihood of deaths due to neonatal infection (HR 1.8, 95% CI 1.0-3.1), and preterm labor/contractions of those due to respiratory (HR 1.5, 95% CI 1.1-2.0) and gastrointestinal diseases (HR 5.8, 95% CI 2.1-16.3). In addition, a birth weight z-score <−1 was associated with increasing hazards of death resulting from asphyxia, late infections, respiratory, and gastrointestinal diseases.
Conclusions |
Different complications of pregnancy lead to different cause-specific mortality patterns in very preterm infants.
Le texte complet de cet article est disponible en PDF.Keyword : BPD, GA, HR, IUGR, IVH, NICU, PPROM
Plan
| The ACTION project was funded by the Italian Ministry of Health (Programma di Ricerca Finalizzata 2002-2004) and coordinated by the Unit of Epidemiology of the Regional Agency for Health of Tuscany. Additional funding was provided by the Bambino Gesù Hospital for data analysis. The authors declare no conflicts of interest. |
Vol 162 - N° 6
P. 1125 - juin 2013 Retour au numéro
Article précédent
- Late-Onset Sepsis in Very Low Birth Weight Infants from Singleton and Multiple-Gestation Births
- Nansi S. Boghossian, Grier P. Page, Edward F. Bell, Barbara J. Stoll, Jeffrey C. Murray, C. Michael Cotten, Seetha Shankaran, Michele C. Walsh, Abbot R. Laptook, Nancy S. Newman, Ellen C. Hale, Scott A. McDonald, Abhik Das, Rosemary D. Higgins, Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network ∗
- Positioning Effects on Lung Function and Breathing Pattern in Premature Newborns
- Georgette Gouna, Thameur Rakza, Elaine Kuissi, Thomas Pennaforte, Sebastien Mur, Laurent Storme
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?