RT Journal Article
SR Electronic
T1 Active perinatal care of preterm infants in the German Neonatal Network
JF Archives of Disease in Childhood - Fetal and Neonatal Edition
JO Arch Dis Child Fetal Neonatal Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 190
OP 195
DO 10.1136/archdischild-2018-316770
VO 105
IS 2
A1 Humberg, Alexander
A1 Härtel, Christoph
A1 Rausch, Tanja K.
A1 Stichtenoth, Guido
A1 Jung, Philipp
A1 Wieg, Christian
A1 Kribs, Angela
A1 von der Wense, Axel
A1 Weller, Ursula
A1 Höhn, Thomas
A1 Olbertz, Dirk M.
A1 Felderhoff-Müser, Ursula
A1 Rossi, Rainer
A1 Teig, Norbert
A1 Heitmann, Friedhelm
A1 Schmidtke, Susanne
A1 Bohnhorst, Bettina
A1 Vochem, Matthias
A1 Segerer, Hugo
A1 Möller, Jens
A1 Eichhorn, Joachim G
A1 Wintgens, Jürgen
A1 Böttger, Ralf
A1 Hubert, Mechthild
A1 Dördelmann, Michael
A1 Hillebrand, Georg
A1 Roll, Claudia
A1 Jensen, Reinhard
A1 Zemlin, Michael
A1 Mögel, Michael
A1 Werner, Claudius
A1 Schäfer, Stefan
A1 Schaible, Thomas
A1 Franz, Axel
A1 Heldmann, Michael
A1 Ehlers, Silke
A1 Kannt, Olaf
A1 Orlikowsky, Thorsten
A1 Gerleve, Hubert
A1 Schneider, Katja
A1 Haase, Roland
A1 Böckenholt, Kai
A1 Linnemann, Knud
A1 Herting, Egbert
A1 Göpel, Wolfgang
YR 2020
UL http://fn.bmj.com/content/105/2/190.abstract
AB Objective To determine if survival rates of preterm infants receiving active perinatal care improve over time.Design The German Neonatal Network is a cohort study of preterm infants with birth weight <1500 g. All eligible infants receiving active perinatal care are registered. We analysed data of patients discharged between 2011 and 2016.Setting 43 German level III neonatal intensive care units (NICUs).Patients 8222 preterm infants with a gestational age between 22/0 and 28/6 weeks who received active perinatal care.Interventions Participating NICUs were grouped according to their specific survival rate from 2011 to 2013 to high (percentile >P75), intermediate (P25–P75) and low (<P25) survival. We compared these survival rates with data in 2014–2016.Main outcome measures Death by any cause before discharge.Results Total survival increased from 85.8% in 2011–2013 to 87.4% in 2014–2016. This increase was due to reduced mortality of NICUs with low survival rates in 2011–2013. Survival increased in these centres from 53% to 64% in the 22–24 weeks strata and from 73% to 84% in the 25–26 weeks strata.Conclusions Our data support previous reports that active perinatal care of very immature infants improves outcomes at the border of viability and survival rates at higher gestational ages. The high total number of surviving infants below 24 weeks of gestation challenges national recommendations exclusively referring to gestational age as the single criterion for providing active care. However, more data are needed before recommendations for parental counselling should be reconsidered.Trial registration Approval by the local institutional review board for research in human subjects of the University of Lübeck (file number 08–022) and by the local ethic committees of all participating centres has been given.