|
|
||||||||||||||
|
|
|||||||||||||||
ORIGINAL ARTICLE |
1 Epidemiological Research Unit on Perinatal and Womens Health, U149 INSERM Villejuif, France
2 Department of Neonatology, Hôpital Béclère, Clamart, France
3 Maternité Régionale, Nancy, France
4 Department of Neonatology, Besançon Hospital, Besançon, France
5 INSERM U558, Toulouse, France
6 Observatoire Régional de la Santé, Montpellier, France
7 Department of Neonatology, Hôpital Charles Nicolle, Rouen, France
8 Department of Neonatology, Hôpital de Hautepierre, Strasbourg, France
9 Department of Neonatology, Hôpital Mère Enfant, Nantes, France
10 Department of Neonatology, Hôpital Jeanne de Flandres, Lille, France
Correspondence to:
Correspondence to:
Dr Larroque
INSERM U149, 16 avenue Paul Vaillant Couturier, 94807 Villejuif cedex, France; larroque{at}vjf.inserm.fr
Objective: To evaluate the outcome for all infants born before 33 weeks gestation until discharge from hospital.
Design: A prospective observational population based study.
Setting: Nine regions of France in 1997.
Patients: All births or late terminations of pregnancy for fetal or maternal reasons between 22 and 32 weeks gestation.
Main outcome measure: Life status: stillbirth, live birth, death in delivery room, death in intensive care, decision to limit intensive care, survival to discharge.
Results: A total of 722 late terminations, 772 stillbirths, and 2901 live births were recorded. The incidence of very preterm births was 1.3 per 100 live births and stillbirths. The survival rate for births between 22 and 32 weeks was 67% of all births (including stillbirths), 85% of live births, and 89% of infants admitted to neonatal intensive care units. Survival increased with gestational age: 31% of all infants born alive at 24 weeks survived to discharge, 78% at 28 weeks, and 97% at 32 weeks. Survival among live births was lower for small for gestational age infants, multiple births, and boys. Overall, 50% of deaths after birth followed decisions to withhold or withdraw intensive care: 66% of deaths in the delivery room, decreasing with increasing gestational age; 44% of deaths in the neonatal intensive care unit, with little variation with gestational age.
Conclusion: Among very preterm babies, chances of survival varies greatly according to the length of gestation. At all gestational ages, a large proportion of deaths are associated with a decision to limit intensive care.
Keywords: very preterm infants; mortality; survival; intensive care
This article has been cited by other articles:
![]() |
J.-C. Roze, S. Denizot, R. Carbajal, P.-Y. Ancel, M. Kaminski, C. Arnaud, P. Truffert, S. Marret, J. Matis, G. Thiriez, et al. Prolonged Sedation and/or Analgesia and 5-Year Neurodevelopment Outcome in Very Preterm Infants: Results From the EPIPAGE Cohort Arch Pediatr Adolesc Med, August 1, 2008; 162(8): 728 - 733. [Abstract] [Full Text] [PDF] |
||||
![]() |
D. J Field, J. S Dorling, B. N Manktelow, and E. S Draper Survival of extremely premature babies in a geographically defined population: prospective cohort study of 1994-9 compared with 2000-5 BMJ, May 31, 2008; 336(7655): 1221 - 1223. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. S. Pignotti and G. Donzelli Perinatal Care at the Threshold of Viability: An International Comparison of Practical Guidelines for the Treatment of Extremely Preterm Births Pediatrics, January 1, 2008; 121(1): e193 - e198. [Abstract] [Full Text] [PDF] |
||||
![]() |
C. Arnaud, L. Daubisse-Marliac, M. White-Koning, V. Pierrat, B. Larroque, H. Grandjean, C. Alberge, S. Marret, A. Burguet, P.-Y. Ancel, et al. Prevalence and Associated Factors of Minor Neuromotor Dysfunctions at Age 5 Years in Prematurely Born Children: The EPIPAGE Study Arch Pediatr Adolesc Med, November 1, 2007; 161(11): 1053 - 1061. [Abstract] [Full Text] [PDF] |
||||
![]() |
N Evans, J Hutchinson, J M Simpson, D Donoghue, B Darlow, D Henderson-Smart, and on behalf of the Australian and New Zealand Neonat Prenatal predictors of mortality in very preterm infants cared for in the Australian and New Zealand Neonatal Network Arch. Dis. Child. Fetal Neonatal Ed., January 1, 2007; 92(1): F34 - F40. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. Hentschel, K. Lindner, M. Krueger, and S. Reiter-Theil Restriction of Ongoing Intensive Care in Neonates: A Prospective Study Pediatrics, August 1, 2006; 118(2): 563 - 569. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. Vieux, J. Fresson, J.-M. Hascoet, B. Blondel, P. Truffert, J.-C. Roze, J. Matis, G. Thiriez, C. Arnaud, L. Marpeau, et al. Improving Perinatal Regionalization by Predicting Neonatal Intensive Care Requirements of Preterm Infants: An EPIPAGE-Based Cohort Study Pediatrics, July 1, 2006; 118(1): 84 - 90. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Delobel-Ayoub, M. Kaminski, S. Marret, A. Burguet, L. Marchand, S. N'Guyen, J. Matis, G. Thiriez, J. Fresson, C. Arnaud, et al. Behavioral outcome at 3 years of age in very preterm infants: the EPIPAGE study. Pediatrics, June 1, 2006; 117(6): 1996 - 2005. [Abstract] [Full Text] [PDF] |
||||
![]() |
P.-Y. Ancel, F. Livinec, B. Larroque, S. Marret, C. Arnaud, V. Pierrat, M. Dehan, S. N'Guyen, B. Escande, A. Burguet, et al. Cerebral Palsy Among Very Preterm Children in Relation to Gestational Age and Neonatal Ultrasound Abnormalities: The EPIPAGE Cohort Study Pediatrics, March 1, 2006; 117(3): 828 - 835. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. Fily, V. Pierrat, V. Delporte, G. Breart, P. Truffert, and on behalf of the EPIPAGE Nord-Pas-de-Calais Study Factors Associated With Neurodevelopmental Outcome at 2 Years After Very Preterm Birth: The Population-Based Nord-Pas-de-Calais EPIPAGE Cohort Pediatrics, February 1, 2006; 117(2): 357 - 366. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Livinec, P.-Y. Ancel, S. Marret, C. Arnaud, J. Fresson, V. Pierrat, J.-C. Roze, B. Escande, G. Thiriez, B. Larroque, et al. Prenatal Risk Factors for Cerebral Palsy in Very Preterm Singletons and Twins Obstet. Gynecol., June 1, 2005; 105(6): 1341 - 1347. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. Ho and S. Saigal Current Survival and Early Outcomes of Infants of Borderline Viability NeoReviews, March 1, 2005; 6(3): e123 - e132. [Full Text] [PDF] |
||||
![]() |
A Burguet, M Kaminski, P Truffert, A Menget, L Marpeau, M Voyer, J C Roze, B Escande, G Cambonie, J M Hascoet, et al. Does smoking in pregnancy modify the impact of antenatal steroids on neonatal respiratory distress syndrome? Results of the Epipage study Arch. Dis. Child. Fetal Neonatal Ed., January 1, 2005; 90(1): F41 - F45. [Abstract] [Full Text] [PDF] |
||||
![]() |
R. J. Boyle Ethical Issues in the Care of the Neonate: Overview NeoReviews, November 1, 2004; 5(11): e471 - e476. [Full Text] [PDF] |
||||
![]() |
T Lacaze-Masmonteil, P Truffert, D Pinquier, P Daoud, G Goldfarb, E Vicaut, and B Fauroux Lower respiratory tract illness and RSV prophylaxis in very premature infants Arch. Dis. Child., June 1, 2004; 89(6): 562 - 567. [Abstract] [Full Text] [PDF] |
||||
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
| ARCH DIS CHILD | FETAL NEONATAL ED | ED PRACTICE |