PS-047 Tradeoffs Between Mortality And Morbidity For Very Preterm Infants: Results From The Epice Cohort
Background and aimsThere is concern that declines in mortality after very preterm birth are accompanied by higher morbidity as more fragile babies survive. We investigated whether rates of severe neonatal morbidity were higher in regions with low versus high mortality.MethodsThe EPICE cohort include...
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| Veröffentlicht in: | Archives of disease in childhood 2014-10, Vol.99 (Suppl 2), p.A129-A129 |
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| creator | Zeitlin, J Edstedt Bonamy, AK Bonet, M Draper, ES E, Epice |
| description | Background and aimsThere is concern that declines in mortality after very preterm birth are accompanied by higher morbidity as more fragile babies survive. We investigated whether rates of severe neonatal morbidity were higher in regions with low versus high mortality.MethodsThe EPICE cohort included all births between 22+0 and 31+6 weeks of gestation in 19 European regions in 2011–2012 (N = 7878 live births). We divided the cohort into tertiles based on regional in-hospital mortality rates excluding deaths due to congenital anomalies: low ( |
| doi_str_mv | 10.1136/archdischild-2014-307384.344 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2138061268</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2138061268</sourcerecordid><originalsourceid>FETCH-LOGICAL-c1354-721a9b09e0b78662356d7562d7ba34437150082b90dbe5e3826376343f4f12203</originalsourceid><addsrcrecordid>eNpNkM1OwzAQhC0EEqXwDpbgGlj_xHYQl1K1UKmICgpXy4kdJVUbFzsV6o0LL8qTkKgcOK1mNZrd-RC6InBNCBM3JhSVrWNR1WubUCA8YSCZ4teM8yM0IFyobs35MRoAAEsypdQpOotxBUCoUmyAVovXBLj8-fpeBmOdL8uI71376VyDn3xozbpu93jU2F7lte3V1Af87sIeL4JrXdjgWVOapo23-MXF3bqNeBr8Bi8rhyfbunB47Ksu6hydlGYd3cXfHKK36WQ5fkzmzw-z8WieFISlPJGUmCyHzEEulRCUpcLKVFArc9P1YpKkAIrmGdjcpY4pKpgUjLOSl4RSYEN0ecjdBv-xc7HVK78LTXdSU8IUCEKF6lx3B1cRfIzBlXob6o0Je01A93T1f7q6p6sPdHX_xS_JQnBb</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2138061268</pqid></control><display><type>article</type><title>PS-047 Tradeoffs Between Mortality And Morbidity For Very Preterm Infants: Results From The Epice Cohort</title><source>BMJ Journals - NESLi2</source><creator>Zeitlin, J ; Edstedt Bonamy, AK ; Bonet, M ; Draper, ES ; E, Epice</creator><creatorcontrib>Zeitlin, J ; Edstedt Bonamy, AK ; Bonet, M ; Draper, ES ; E, Epice</creatorcontrib><description>Background and aimsThere is concern that declines in mortality after very preterm birth are accompanied by higher morbidity as more fragile babies survive. We investigated whether rates of severe neonatal morbidity were higher in regions with low versus high mortality.MethodsThe EPICE cohort included all births between 22+0 and 31+6 weeks of gestation in 19 European regions in 2011–2012 (N = 7878 live births). We divided the cohort into tertiles based on regional in-hospital mortality rates excluding deaths due to congenital anomalies: low (<12.0%), medium (12.0 to 14.9%) and high (≥15.0%). Severe neonatal morbidity was defined as intraventricular haemorrhage grades III-IV, cystic periventricular leukomalacia, surgery/peritoneal drainage for necrotizing enterocolitis or retinopathy of prematurity (grades ≥3). Bronchopulmonary dysplasia (BPD) was analysed separately. Multilevel logistic regressions were used to model regional-level effects.Results6770 infants were discharged home. 12.2% had at least one severe morbidity (regional range: 3.8% to 24.4%) and 15.3% had BPD (regional range: 6.7% to 34.9%). Rates of severe morbidity were 11.7%, 12.1% and 12.9% in low, medium and high mortality regions, respectively (p = 0.45). BPD was higher in low mortality regions (18.7%,16.7% and 10.2%, respectively (p < 0.001). The odds ratio for severe morbidity associated with birth in a low versus high mortality region was 0.83 (95% CI: 0.55–1.25) and for BPD was 1.81 (95% CI: 1.08–3.0).ConclusionRates of severe neonatal morbidity and BPD vary greatly between regions in Europe. BPD rates were higher in lower mortality regions, but this was not true for other morbidities.</description><identifier>ISSN: 0003-9888</identifier><identifier>EISSN: 1468-2044</identifier><identifier>DOI: 10.1136/archdischild-2014-307384.344</identifier><language>eng</language><publisher>London: BMJ Publishing Group LTD</publisher><subject>Attrition (Research Studies) ; Birth ; Births ; Congenital defects ; Dysplasia ; Enterocolitis ; Gestation ; Hemorrhage ; Infants ; Morbidity ; Mortality ; Necrotizing enterocolitis ; Neonates ; Peritoneum ; Periventricular leukomalacia ; Pregnancy ; Premature babies ; Premature birth ; Retinopathy ; Surgery ; Young Children</subject><ispartof>Archives of disease in childhood, 2014-10, Vol.99 (Suppl 2), p.A129-A129</ispartof><rights>2014 2014, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,3183,27905,27906</link.rule.ids></links><search><creatorcontrib>Zeitlin, J</creatorcontrib><creatorcontrib>Edstedt Bonamy, AK</creatorcontrib><creatorcontrib>Bonet, M</creatorcontrib><creatorcontrib>Draper, ES</creatorcontrib><creatorcontrib>E, Epice</creatorcontrib><title>PS-047 Tradeoffs Between Mortality And Morbidity For Very Preterm Infants: Results From The Epice Cohort</title><title>Archives of disease in childhood</title><description>Background and aimsThere is concern that declines in mortality after very preterm birth are accompanied by higher morbidity as more fragile babies survive. We investigated whether rates of severe neonatal morbidity were higher in regions with low versus high mortality.MethodsThe EPICE cohort included all births between 22+0 and 31+6 weeks of gestation in 19 European regions in 2011–2012 (N = 7878 live births). We divided the cohort into tertiles based on regional in-hospital mortality rates excluding deaths due to congenital anomalies: low (<12.0%), medium (12.0 to 14.9%) and high (≥15.0%). Severe neonatal morbidity was defined as intraventricular haemorrhage grades III-IV, cystic periventricular leukomalacia, surgery/peritoneal drainage for necrotizing enterocolitis or retinopathy of prematurity (grades ≥3). Bronchopulmonary dysplasia (BPD) was analysed separately. Multilevel logistic regressions were used to model regional-level effects.Results6770 infants were discharged home. 12.2% had at least one severe morbidity (regional range: 3.8% to 24.4%) and 15.3% had BPD (regional range: 6.7% to 34.9%). Rates of severe morbidity were 11.7%, 12.1% and 12.9% in low, medium and high mortality regions, respectively (p = 0.45). BPD was higher in low mortality regions (18.7%,16.7% and 10.2%, respectively (p < 0.001). The odds ratio for severe morbidity associated with birth in a low versus high mortality region was 0.83 (95% CI: 0.55–1.25) and for BPD was 1.81 (95% CI: 1.08–3.0).ConclusionRates of severe neonatal morbidity and BPD vary greatly between regions in Europe. BPD rates were higher in lower mortality regions, but this was not true for other morbidities.</description><subject>Attrition (Research Studies)</subject><subject>Birth</subject><subject>Births</subject><subject>Congenital defects</subject><subject>Dysplasia</subject><subject>Enterocolitis</subject><subject>Gestation</subject><subject>Hemorrhage</subject><subject>Infants</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Necrotizing enterocolitis</subject><subject>Neonates</subject><subject>Peritoneum</subject><subject>Periventricular leukomalacia</subject><subject>Pregnancy</subject><subject>Premature babies</subject><subject>Premature birth</subject><subject>Retinopathy</subject><subject>Surgery</subject><subject>Young Children</subject><issn>0003-9888</issn><issn>1468-2044</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNpNkM1OwzAQhC0EEqXwDpbgGlj_xHYQl1K1UKmICgpXy4kdJVUbFzsV6o0LL8qTkKgcOK1mNZrd-RC6InBNCBM3JhSVrWNR1WubUCA8YSCZ4teM8yM0IFyobs35MRoAAEsypdQpOotxBUCoUmyAVovXBLj8-fpeBmOdL8uI71376VyDn3xozbpu93jU2F7lte3V1Af87sIeL4JrXdjgWVOapo23-MXF3bqNeBr8Bi8rhyfbunB47Ksu6hydlGYd3cXfHKK36WQ5fkzmzw-z8WieFISlPJGUmCyHzEEulRCUpcLKVFArc9P1YpKkAIrmGdjcpY4pKpgUjLOSl4RSYEN0ecjdBv-xc7HVK78LTXdSU8IUCEKF6lx3B1cRfIzBlXob6o0Je01A93T1f7q6p6sPdHX_xS_JQnBb</recordid><startdate>201410</startdate><enddate>201410</enddate><creator>Zeitlin, J</creator><creator>Edstedt Bonamy, AK</creator><creator>Bonet, M</creator><creator>Draper, ES</creator><creator>E, Epice</creator><general>BMJ Publishing Group LTD</general><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88B</scope><scope>88E</scope><scope>88I</scope><scope>8A4</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>CJNVE</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>LK8</scope><scope>M0P</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEDU</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope></search><sort><creationdate>201410</creationdate><title>PS-047 Tradeoffs Between Mortality And Morbidity For Very Preterm Infants: Results From The Epice Cohort</title><author>Zeitlin, J ; Edstedt Bonamy, AK ; Bonet, M ; Draper, ES ; E, Epice</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1354-721a9b09e0b78662356d7562d7ba34437150082b90dbe5e3826376343f4f12203</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Attrition (Research Studies)</topic><topic>Birth</topic><topic>Births</topic><topic>Congenital defects</topic><topic>Dysplasia</topic><topic>Enterocolitis</topic><topic>Gestation</topic><topic>Hemorrhage</topic><topic>Infants</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Necrotizing enterocolitis</topic><topic>Neonates</topic><topic>Peritoneum</topic><topic>Periventricular leukomalacia</topic><topic>Pregnancy</topic><topic>Premature babies</topic><topic>Premature birth</topic><topic>Retinopathy</topic><topic>Surgery</topic><topic>Young Children</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zeitlin, J</creatorcontrib><creatorcontrib>Edstedt Bonamy, AK</creatorcontrib><creatorcontrib>Bonet, M</creatorcontrib><creatorcontrib>Draper, ES</creatorcontrib><creatorcontrib>E, Epice</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection【Remote access available】</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Education Database (Alumni Edition)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>Education Periodicals</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central</collection><collection>Social Science Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>ProQuest Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Education Collection (Proquest) (PQ_SDU_P3)</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>Consumer Health Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>ProQuest Education Journals</collection><collection>ProQuest Family Health</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Science Journals</collection><collection>ProQuest Biological Science Journals</collection><collection>ProQuest One Education</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><jtitle>Archives of disease in childhood</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zeitlin, J</au><au>Edstedt Bonamy, AK</au><au>Bonet, M</au><au>Draper, ES</au><au>E, Epice</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>PS-047 Tradeoffs Between Mortality And Morbidity For Very Preterm Infants: Results From The Epice Cohort</atitle><jtitle>Archives of disease in childhood</jtitle><date>2014-10</date><risdate>2014</risdate><volume>99</volume><issue>Suppl 2</issue><spage>A129</spage><epage>A129</epage><pages>A129-A129</pages><issn>0003-9888</issn><eissn>1468-2044</eissn><abstract>Background and aimsThere is concern that declines in mortality after very preterm birth are accompanied by higher morbidity as more fragile babies survive. We investigated whether rates of severe neonatal morbidity were higher in regions with low versus high mortality.MethodsThe EPICE cohort included all births between 22+0 and 31+6 weeks of gestation in 19 European regions in 2011–2012 (N = 7878 live births). We divided the cohort into tertiles based on regional in-hospital mortality rates excluding deaths due to congenital anomalies: low (<12.0%), medium (12.0 to 14.9%) and high (≥15.0%). Severe neonatal morbidity was defined as intraventricular haemorrhage grades III-IV, cystic periventricular leukomalacia, surgery/peritoneal drainage for necrotizing enterocolitis or retinopathy of prematurity (grades ≥3). Bronchopulmonary dysplasia (BPD) was analysed separately. Multilevel logistic regressions were used to model regional-level effects.Results6770 infants were discharged home. 12.2% had at least one severe morbidity (regional range: 3.8% to 24.4%) and 15.3% had BPD (regional range: 6.7% to 34.9%). Rates of severe morbidity were 11.7%, 12.1% and 12.9% in low, medium and high mortality regions, respectively (p = 0.45). BPD was higher in low mortality regions (18.7%,16.7% and 10.2%, respectively (p < 0.001). The odds ratio for severe morbidity associated with birth in a low versus high mortality region was 0.83 (95% CI: 0.55–1.25) and for BPD was 1.81 (95% CI: 1.08–3.0).ConclusionRates of severe neonatal morbidity and BPD vary greatly between regions in Europe. BPD rates were higher in lower mortality regions, but this was not true for other morbidities.</abstract><cop>London</cop><pub>BMJ Publishing Group LTD</pub><doi>10.1136/archdischild-2014-307384.344</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Attrition (Research Studies) Birth Births Congenital defects Dysplasia Enterocolitis Gestation Hemorrhage Infants Morbidity Mortality Necrotizing enterocolitis Neonates Peritoneum Periventricular leukomalacia Pregnancy Premature babies Premature birth Retinopathy Surgery Young Children |
| title | PS-047 Tradeoffs Between Mortality And Morbidity For Very Preterm Infants: Results From The Epice Cohort |
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