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Deaths in Preterm Infants: Changing Pathology Over 2 Decades

Lookup NU author(s): Dr Janet Berrington, Mary Bythell, Dr Christopher Wright, Professor Nicholas EmbletonORCiD

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Abstract

Objective To establish how cause of death for live-born preterm infants (24-31 weeks gestation) has changed in a single large UK population over 2 decades. Study design This was an interrogation of a population-based survey of >680 000 live births (between 1988 and 2008) for deaths in the first postnatal year. We collected cause of death grouped into major etiologies: respiratory, infection, malformation, necrotizing enterocolitis (NEC), and other. Data were analyzed in three 7-year epochs and 2 gestational groups (<27 and 28-31 weeks). Numbers, rates per 1000 live births, and proportional contributions to each epoch were analyzed. Results A total of 1504 deaths occurred. The infants who died had a median gestational age of 26 weeks (IQR, 25-28 weeks) and a median birth weight of 880 g (IQR, 700-1170 g). The number of deaths decreased with each later epoch (from 671 to 473 and then to 360), as did the proportion of deaths from respiratory causes (64% to 62% and then to 49%). The proportion of deaths occurring after 40 weeks postmenstrual age remained stable across the 3 epochs (8.8%, 8%, and 8%). Deaths from infection and NEC increased with time (from 11% to 13% and then to 21%), as did median time to death (from 2.7 to 3.8 days). Conclusion Infection and NEC are increasingly prevalent causes of death in preterm infants. (J Pediatr 2012;160:49-53).


Publication metadata

Author(s): Berrington JE, Hearn RI, Bythell M, Wright C, Embleton ND

Publication type: Article

Publication status: Published

Journal: Journal of Pediatrics

Year: 2012

Volume: 160

Issue: 1

Pages: 49-U94

Print publication date: 24/08/2011

ISSN (print): 0022-3476

ISSN (electronic): 1097-6833

Publisher: Mosby, Inc.

URL: http://dx.doi.org/10.1016/j.jpeds.2011.06.046

DOI: 10.1016/j.jpeds.2011.06.046


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