Original ArticleNeonatal Outcomes of Very Low Birth Weight and Very Preterm Neonates: An International Comparison
Section snippets
Methods
This retrospective cohort study included infants born weighing <1500 g at 240 to 316 weeks' gestation and admitted to the contributing neonatal units of participating countries during 2007-2010 (2008-2010 for the UKNC). We excluded infants born at <24 weeks' gestation because culture, practices, and guidelines22, 23 concerning resuscitation differed at lower gestational ages, which was reflected in widely differing rates of neonates born at <24 weeks' gestation admitted to networks. This was a
Results
Of the registered total 75 578 neonates in these databases, after exclusions, the final study sample comprised 58 004 (77%) of the 75 578 very low birth weight infants (Table II). Infant characteristics are presented in Table III, with significant differences detected between countries for all characteristics except sex. Notably, the rate of multiple births was greatest in Israel (42%) and lowest in Japan (24%), which also had the lowest rate of antenatal steroid use (49%). The rate of cesarean
Discussion
In this large, multicenter, multinational cohort of very preterm and very low birth weight infants born weighing <1500 g at 240 to 316 weeks' gestation, we identified marked variation in the composite outcome, as well as mortality and each morbidity across countries. For example, Japan had the lowest mortality but the greatest rate of treatment for retinopathy of prematurity, whereas Spain had the greatest mortality but a relatively lower rate of bronchopulmonary dysplasia. These variations
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Funding for iNeo of Neonates has been provided by a Canadian Institutes of Health Research (FRN87518) Chair in Reproductive and Child Health Services and Policy Research (to P.S.). Additional funding is available at www.jpeds.com (Appendix 2). The authors declare no conflicts of interest.
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Current address: Phoenix Children's Hospital, Phoenix, AZ.
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List of additional investigators of iNeo of Neonates is available at www.jpeds.com (Appendix 1).