Document Detail

Risk factors and estimation tool for death among extremely premature infants: a national study.
MedLine Citation:
PMID:  20351002     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The goals were to assess risk factors and mortality rate changes over time and to develop simple estimates of mortality rates for specific groups of infants at 23 to 26 weeks of gestation. METHODS: Data from the Israel national very low birth weight infant database on 3768 infants born in 1995-2006 with gestational ages (GAs) of 23 to 26 weeks were evaluated, and we developed a tool for estimating infants' mortality rates. RESULTS: Major factors associated with death were GA, gender-specific birth weight percentile, prenatal steroid therapy, and multiple births. There was a steady decrease in mortality rates for all GAs during the study period. In 2004-2006, mortality rates before discharge were 89%, 67%, 46%, and 26% for infants with GAs of 23, 24, 25, and 26 weeks, respectively. Estimated mortality rates were calculated as the sum of the percentages determined for each of 4 parameters, as follows: GA of 26, 25, 24, or 23 weeks, 0%, 17%, 34%, and 51%, respectively (P < .001); birth weight percentile of >75th, 25th to 75th, or <25th, 0%, 16%, and 32%, respectively (P < .001); no prenatal steroid treatment, +22% (P < .001); multiple birth, +7% (P = .1). Estimated mortality rates for the 48 subgroups of infants ranged from 0% to 100% and correlated well with observed rates (intraclass correlation coefficient: 0.89). CONCLUSION: Mortality rates for infants born at 23 to 26 weeks of gestation could be estimated simply on the basis of GA, gender-specific birth weight quartiles, prenatal corticosteroid therapy, and multiple births.
David Bader; Amir Kugelman; Valentina Boyko; Orna Levitzki; Liat Lerner-Geva; Arieh Riskin; Brian Reichman;
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2010-03-29
Journal Detail:
Title:  Pediatrics     Volume:  125     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-04-02     Completed Date:  2010-04-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  696-703     Citation Subset:  AIM; IM    
Bnai Zion Medical Center, Department of Neonatology, 47 Golomb St, Haifa, 31048, Israel.
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MeSH Terms
Cause of Death / trends
Databases, Factual / statistics & numerical data,  trends
Infant, Newborn
Infant, Premature, Diseases / diagnosis,  epidemiology,  mortality*
Infant, Very Low Birth Weight*
Israel / epidemiology
Mortality / trends*
Prospective Studies
Risk Factors
Comment In:
Pediatrics. 2010 Apr;125(4):813-6   [PMID:  20351013 ]

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