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Trends in Perinatal Practices and Neonatal Outcomes of Very Low Birth Weight Infants during a 16-year Period at NEOCOSUR Centers.

Authors
  • D'Apremont, Ivonne1
  • Marshall, Guillermo2
  • Musalem, Claudia3
  • Mariani, Gonzalo4
  • Musante, Gabriel5
  • Bancalari, Aldo6
  • Fabres, Jorge3
  • Mena, Patricia1
  • Zegarra, Jaime7
  • Tavosnanska, Jorge8
  • Lacarrubba, Jose9
  • Solana, Claudio10
  • Vaz Ferreira, Catalina11
  • Herrera, Tamara11
  • Villarroel, Luis2
  • Tapia, José L12
  • 1 Department of Neonatology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago de, Chile; Neonatal Unit, Hospital Dr. Sotero del Río, Santiago, Chile. , (Chile)
  • 2 Departament of Public Health, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile. , (Chile)
  • 3 Department of Neonatology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago de, Chile. , (Chile)
  • 4 Department of Pediatrics, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. , (Argentina)
  • 5 Maternal and Infant Department, Hospital Universitario Austral, Pilar, Argentina. , (Argentina)
  • 6 Hospital Guillermo Grant, Concepción, Faculty of Medicine, Universidad de Concepción, Chile. , (Chile)
  • 7 Department of Pediatrics, Universidad Cayetano Heredia, Lima, Perú.
  • 8 Hospital Juan Fernández and Faculty of Medicine, Universidad de Buenos Aires, Buenos Aires, Argentina. , (Argentina)
  • 9 Hospital de Clínicas, Universidad de Asunción, Paraguay. , (Paraguay)
  • 10 Division of Neonatology, Hospital RamSardá, Universidad de Buenos Aires, Buenos Aires, Argentina. , (Argentina)
  • 11 Department of Neonatology, Centro Hospitalario Pereira Rossell, Universidad de la República, Montevideo, Uruguay. , (Uruguay)
  • 12 Department of Neonatology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago de, Chile. Electronic address: [email protected] , (Chile)
Type
Published Article
Journal
The Journal of pediatrics
Publication Date
Oct 01, 2020
Volume
225
Identifiers
DOI: 10.1016/j.jpeds.2020.05.040
PMID: 32454113
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To describe trends in mortality, major morbidity, and perinatal care practices of very low birth weight infants born at NEOCOSUR Neonatal Network centers from January 1, 2001, through December 31, 2016. A retrospective analysis of prospectively collected data from all inborn infants with a birthweight of 500-1500 g and 23-35 weeks of gestation. We examined data for 13 987 very low birth weight infants with a mean birth weight of 1081 ± 281 g and a gestational age of 28.8 ± 2.9 weeks. Overall mortality was 26.8% without significant changes throughout the study period. Decreases in early onset sepsis from 6.3% to 2.8% (P <.001), late onset sepsis from 21.1% to 19.5% (P = .002), retinopathy of prematurity from 21.3% to 13.8% (P <.001), and hydrocephalus from 3.8% to 2.4% (P <.001), were observed. The incidence for bronchopulmonary dysplasia decreased from 17.3% to 16% (P = .043), incidence of severe intraventricular hemorrhage was 10.4%, necrotizing enterocolitis 11.1%, and periventricular leukomalacia 3.8%, and did not change over the study period. Administration of antenatal corticosteroids increased from 70.2% to 82.3% and cesarean delivery from 65.9% to 75.4% (P <.001). The use of conventional mechanical ventilation decreased from 67.7% to 63.9% (P <.001) and continuous positive airway pressure use increased from 41.3% to 64.3% (P <.001). Survival without major morbidity increased from 37.4% to 44.5% over the study period (P <.001). Progress in perinatal and neonatal care at network centers was associated with an improvement in survival without major morbidity of very low birth weight infants during a 16-year period. However, overall mortality remained unchanged. Copyright © 2020 Elsevier Inc. All rights reserved.

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