Meny

Javascript is not activated in your browser. This website needs javascript activated to work properly.
Du är här

One-Year Survival of Extremely Preterm Infants After Active Perinatal Care in Sweden

Författare:
  • Mats Blennow
  • Uwe Ewald
  • Tomas Fritz
  • Per Ake Holmgren
  • Annika Jeppsson
  • Eva Lindberg
  • Anita Lundqvist
  • Solveig Norden Lindeberg
  • Elisabeth Olhager
  • Ingrid Ostlund
  • Marija Simic
  • Gunnar Sjoers
  • Lennart Stigson
  • Vineta Fellman
  • Lena Hellstrom-Westas
  • Mikael Norman
  • Magnus Westgren
  • Gerd Holmstrom
  • Ricardo Laurini
  • Karin Stjernqvist (Professor)
  • Karin Källén
  • Hugo Lagercrantz
  • Karel Marsal
  • Fredrik Serenius
  • Margareta Wennergren
  • Tore Nilstun
  • Petra Otterblad Olausson
  • Bo Stromberg
Publiceringsår: 2009
Språk: Engelska
Sidor: 2225-2233
Publikation/Tidskrift/Serie: Jama-Journal Of The American Medical Association
Volym: 301
Nummer: 21
Dokumenttyp: Artikel
Förlag: Amer Medical Assoc

Sammanfattning

Context Up-to-date information on infant survival after extremely preterm birth is needed for assessing perinatal care services, clinical guidelines, and parental counseling. Objective To determine the 1-year survival in all infants born before 27 gestational weeks in Sweden during 2004-2007. Design, Setting, and Patients Population-based prospective observational study of extremely preterm infants (707 live-born and 304 stillbirths) born to 887 mothers in 904 deliveries (102 multiple births) in all obstetric and neonatal units in Sweden from April 1, 2004, to March 31, 2007. Main Outcome Measures Infant survival to 365 days and survival without major neonatal morbidity (intraventricular hemorrhage grade > 2, retinopathy of prematurity stage > 2, periventricular leukomalacia, necrotizing enterocolitis, severe bronchopulmonary dysplasia). Associations between perinatal interventions and survival. Results The incidence of extreme prematurity was 3.3 per 1000 infants. Overall perinatal mortality was 45% (from 93% at 22 weeks to 24% at 26 weeks), with 30% stillbirths, including 6.5% intrapartum deaths. Of live-born infants, 91% were admitted to neonatal intensive care and 70% survived to 1 year of age (95% confidence interval [CI], 67%-73%). The Kaplan-Meier survival estimates for 22, 23, 24, 25, and 26 weeks were 9.8% (95% CI, 4%-23%), 53% ( 95% CI, 44%-63%), 67% (95% CI, 59%-75%), 82% (95% CI, 76%-87%), and 85% ( 95% CI, 81%-90%), respectively. Lower risk of infant death was associated with tocolytic treatment (adjusted for gestational age odds ratio [ OR], 0.43; 95% CI, 0.36-0.52), antenatal corticosteroids (OR, 0.44; 95% CI, 0.24-0.81), surfactant treatment within 2 hours after birth ( OR, 0.47; 95% CI, 0.32-0.71), and birth at a level III hospital (OR, 0.49; 95% CI, 0.32-0.75). Among 1-year survivors, 45% had no major neonatal morbidity. Conclusion During 2004 to 2007, 1-year survival of infants born alive at 22 to 26 weeks of gestation in Sweden was 70% and ranged from 9.8% at 22 weeks to 85% at 26 weeks. JAMA. 2009;301(21):2225-2233 www.jama.com

Disputation

Nyckelord

  • Medicine and Health Sciences

Övriga

Published
Yes
  • ISSN: 0098-7484

Box 117, 221 00 LUND
Telefon 046-222 00 00 (växel)
Telefax 046-222 47 20
lu [at] lu [dot] se

Fakturaadress: Box 188, 221 00 LUND
Organisationsnummer: 202100-3211
Om webbplatsen