Causes and timing of death in extremely premature infants from 2000 through 2011
Ravi M Patel, Sarah Kandefer, Michele C Walsh, Edward F Bell, Waldemar A Carlo, Abbot R Laptook, Pablo J Sánchez, Seetha Shankaran, Krisa P Van Meurs, M Bethany Ball, Ellen C Hale, Nancy S Newman, Abhik Das, Rosemary D Higgins, Barbara J Stoll, Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network, Alan H Jobe, Michael S Caplan, William Oh, Angelita M Hensman, Kristin Basso, Avroy A Fanaroff, William E Truog, Cheri Gauldin, Kurt Schibler, Edward F Donovan, Barbara Alexander, Kate Bridges, Cathy Grisby, Marcia Worley Mersmann, Holly L Mincey, Jody Hessling, Lenora Jackson, Kristin Kirker, Estelle E Fischer, Greg Muthig, Ronald N Goldberg, C Michael Cotten, Kathy J Auten, Kimberley A Fisher, Melody B Lohmeyer, Sandra Grimes, Katherine A Foy, David P Carlton, Linda L Wright, Elizabeth M McClure, Stephanie Wilson Archer, Brenda B Poindexter, James A Lemons, Dianne E Herron, Lucy C Miller, Leslie Dawn Wilson, Leif D Nelin, Sudarshan R Jadcherla, Christine A Fortney, Nehal A Parikh, Bronte Clifford, Amanda Daubenmire, Karen Leonhart, Melanie Stein, Erin Wishloff, Marie G Gantz, W Kenneth Poole, Dennis Wallace, Jeanette O'Donnell Auman, Margaret Crawford, Betty K Hastings, Carolyn M Petrie Huitema, Kristin M Zaterka-Baxter, David K Stevenson, Marian M Adams, Charles E Ahlfors, Andrew W Palmquist, Melinda S Proud, Robert D Stebbins, Ivan D Frantz 3rd, Brenda L MacKinnon, Ellen Nylen, Anne Furey, Namasivayam Ambalavanan, Monica V Collins, Shirley S Cosby, Uday Devaskar, Meena Garg, Teresa Chanlaw, Rachel Geller, Neil N Finer, Maynard R Rasmussen, Paul R Wozniak, Kathy Arnell, Renee Bridge, Clarence Demetrio, Wade Rich, Karen J Johnson, Donia B Campbell, John A Widness, Dan L Ellsbury, Tarah T Colaizy, Charles R Bauer, Shahnaz Duara, Ruth Everett-Thomas, Amy Mur Worth, Kristi L Watterberg, Lu-Ann Papile, Robin K Ohls, Conra Backstrom Lacy, Rebecca A Montman, Barbara Schmidt, Haresh Kirpalani, Sara B DeMauro, Aasma S Chaudhary, Soraya Abbasi, Toni Mancini, Dara Cucinotta, Carl T D'Angio, Dale L Phelps, Ronnie Guillet, Satyan Lakshminrusimha, Linda J Reubens, Erica Burnell, Mary Rowan, Cassandra A Horihan, Holly I M Wadkins, Ann Marie Reynolds, Karen Wynn, Sheldon B Korones, Tina Hudson, Charles R Rosenfeld, Walid A Salhab, Luc P Brion, P Jeannette Burchfield, Alicia Guzman, Gaynelle Hensley, Melissa H Leps, Susie Madison, Nancy A Miller, Diana M Vasil, Lizette E Torres, Lijun Chen, Jon E Tyson, Kathleen A Kennedy, Esther G Akpa, Patricia Ann Orekoya, Beverly Foley Harris, Claudia I Franco, Anna E Lis, Sara Martin, Georgia E McDavid, Patti L Pierce Tate, Maegan C Simmons, Roger G Faix, Bradley A Yoder, Karie Bird, Jill Burnett, Jennifer J Jensen, Karen A Osborne, Cynthia Spencer, Kimberlee Weaver-Lewis, T Michael O'Shea, Nancy J Peters, Rebecca Bara, Mary E Johnson, Kara Sawaya, Richard A Ehrenkranz, Harris Jacobs, Patricia Cervone, Patricia Gettner, Monica Konstantino, JoAnn Poulsen, Janet Taft, Ravi M Patel, Sarah Kandefer, Michele C Walsh, Edward F Bell, Waldemar A Carlo, Abbot R Laptook, Pablo J Sánchez, Seetha Shankaran, Krisa P Van Meurs, M Bethany Ball, Ellen C Hale, Nancy S Newman, Abhik Das, Rosemary D Higgins, Barbara J Stoll, Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network, Alan H Jobe, Michael S Caplan, William Oh, Angelita M Hensman, Kristin Basso, Avroy A Fanaroff, William E Truog, Cheri Gauldin, Kurt Schibler, Edward F Donovan, Barbara Alexander, Kate Bridges, Cathy Grisby, Marcia Worley Mersmann, Holly L Mincey, Jody Hessling, Lenora Jackson, Kristin Kirker, Estelle E Fischer, Greg Muthig, Ronald N Goldberg, C Michael Cotten, Kathy J Auten, Kimberley A Fisher, Melody B Lohmeyer, Sandra Grimes, Katherine A Foy, David P Carlton, Linda L Wright, Elizabeth M McClure, Stephanie Wilson Archer, Brenda B Poindexter, James A Lemons, Dianne E Herron, Lucy C Miller, Leslie Dawn Wilson, Leif D Nelin, Sudarshan R Jadcherla, Christine A Fortney, Nehal A Parikh, Bronte Clifford, Amanda Daubenmire, Karen Leonhart, Melanie Stein, Erin Wishloff, Marie G Gantz, W Kenneth Poole, Dennis Wallace, Jeanette O'Donnell Auman, Margaret Crawford, Betty K Hastings, Carolyn M Petrie Huitema, Kristin M Zaterka-Baxter, David K Stevenson, Marian M Adams, Charles E Ahlfors, Andrew W Palmquist, Melinda S Proud, Robert D Stebbins, Ivan D Frantz 3rd, Brenda L MacKinnon, Ellen Nylen, Anne Furey, Namasivayam Ambalavanan, Monica V Collins, Shirley S Cosby, Uday Devaskar, Meena Garg, Teresa Chanlaw, Rachel Geller, Neil N Finer, Maynard R Rasmussen, Paul R Wozniak, Kathy Arnell, Renee Bridge, Clarence Demetrio, Wade Rich, Karen J Johnson, Donia B Campbell, John A Widness, Dan L Ellsbury, Tarah T Colaizy, Charles R Bauer, Shahnaz Duara, Ruth Everett-Thomas, Amy Mur Worth, Kristi L Watterberg, Lu-Ann Papile, Robin K Ohls, Conra Backstrom Lacy, Rebecca A Montman, Barbara Schmidt, Haresh Kirpalani, Sara B DeMauro, Aasma S Chaudhary, Soraya Abbasi, Toni Mancini, Dara Cucinotta, Carl T D'Angio, Dale L Phelps, Ronnie Guillet, Satyan Lakshminrusimha, Linda J Reubens, Erica Burnell, Mary Rowan, Cassandra A Horihan, Holly I M Wadkins, Ann Marie Reynolds, Karen Wynn, Sheldon B Korones, Tina Hudson, Charles R Rosenfeld, Walid A Salhab, Luc P Brion, P Jeannette Burchfield, Alicia Guzman, Gaynelle Hensley, Melissa H Leps, Susie Madison, Nancy A Miller, Diana M Vasil, Lizette E Torres, Lijun Chen, Jon E Tyson, Kathleen A Kennedy, Esther G Akpa, Patricia Ann Orekoya, Beverly Foley Harris, Claudia I Franco, Anna E Lis, Sara Martin, Georgia E McDavid, Patti L Pierce Tate, Maegan C Simmons, Roger G Faix, Bradley A Yoder, Karie Bird, Jill Burnett, Jennifer J Jensen, Karen A Osborne, Cynthia Spencer, Kimberlee Weaver-Lewis, T Michael O'Shea, Nancy J Peters, Rebecca Bara, Mary E Johnson, Kara Sawaya, Richard A Ehrenkranz, Harris Jacobs, Patricia Cervone, Patricia Gettner, Monica Konstantino, JoAnn Poulsen, Janet Taft
Abstract
Background: Understanding the causes and timing of death in extremely premature infants may guide research efforts and inform the counseling of families.
Methods: We analyzed prospectively collected data on 6075 deaths among 22,248 live births, with gestational ages of 22 0/7 to 28 6/7 weeks, among infants born in study hospitals within the National Institute of Child Health and Human Development Neonatal Research Network. We compared overall and cause-specific in-hospital mortality across three periods from 2000 through 2011, with adjustment for baseline differences.
Results: The number of deaths per 1000 live births was 275 (95% confidence interval [CI], 264 to 285) from 2000 through 2003 and 285 (95% CI, 275 to 295) from 2004 through 2007; the number decreased to 258 (95% CI, 248 to 268) in the 2008-2011 period (P=0.003 for the comparison across three periods). There were fewer pulmonary-related deaths attributed to the respiratory distress syndrome and bronchopulmonary dysplasia in 2008-2011 than in 2000-2003 and 2004-2007 (68 [95% CI, 63 to 74] vs. 83 [95% CI, 77 to 90] and 84 [95% CI, 78 to 90] per 1000 live births, respectively; P=0.002). Similarly, in 2008-2011, as compared with 2000-2003, there were decreases in deaths attributed to immaturity (P=0.05) and deaths complicated by infection (P=0.04) or central nervous system injury (P<0.001); however, there were increases in deaths attributed to necrotizing enterocolitis (30 [95% CI, 27 to 34] vs. 23 [95% CI, 20 to 27], P=0.03). Overall, 40.4% of deaths occurred within 12 hours after birth, and 17.3% occurred after 28 days.
Conclusions: We found that from 2000 through 2011, overall mortality declined among extremely premature infants. Deaths related to pulmonary causes, immaturity, infection, and central nervous system injury decreased, while necrotizing enterocolitis-related deaths increased. (Funded by the National Institutes of Health.).
Conflict of interest statement
No potential conflict of interest relevant to this article was reported.
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Source: PubMed