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Causes and timing of death in extremely premature infants from 2000 through 2011.

Publication ,  Journal Article
Patel, RM; Kandefer, S; Walsh, MC; Bell, EF; Carlo, WA; Laptook, AR; Sánchez, PJ; Shankaran, S; Van Meurs, KP; Ball, MB; Hale, EC; Newman, NS ...
Published in: N Engl J Med
January 22, 2015

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.).

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Published In

N Engl J Med

DOI

EISSN

1533-4406

Publication Date

January 22, 2015

Volume

372

Issue

4

Start / End Page

331 / 340

Location

United States

Related Subject Headings

  • United States
  • Risk Factors
  • Infant, Very Low Birth Weight
  • Infant, Premature, Diseases
  • Infant, Newborn
  • Infant, Extremely Premature
  • Infant Mortality
  • Infant
  • Humans
  • Gestational Age
 

Citation

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Patel, R. M., Kandefer, S., Walsh, M. C., Bell, E. F., Carlo, W. A., Laptook, A. R., … Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network, . (2015). Causes and timing of death in extremely premature infants from 2000 through 2011. N Engl J Med, 372(4), 331–340. https://doi.org/10.1056/NEJMoa1403489
Patel, Ravi M., Sarah Kandefer, Michele C. Walsh, Edward F. Bell, Waldemar A. Carlo, Abbot R. Laptook, Pablo J. Sánchez, et al. “Causes and timing of death in extremely premature infants from 2000 through 2011.N Engl J Med 372, no. 4 (January 22, 2015): 331–40. https://doi.org/10.1056/NEJMoa1403489.
Patel RM, Kandefer S, Walsh MC, Bell EF, Carlo WA, Laptook AR, et al. Causes and timing of death in extremely premature infants from 2000 through 2011. N Engl J Med. 2015 Jan 22;372(4):331–40.
Patel, Ravi M., et al. “Causes and timing of death in extremely premature infants from 2000 through 2011.N Engl J Med, vol. 372, no. 4, Jan. 2015, pp. 331–40. Pubmed, doi:10.1056/NEJMoa1403489.
Patel RM, Kandefer S, Walsh MC, Bell EF, Carlo WA, Laptook AR, Sánchez PJ, Shankaran S, Van Meurs KP, Ball MB, Hale EC, Newman NS, Das A, Higgins RD, Stoll BJ, Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Causes and timing of death in extremely premature infants from 2000 through 2011. N Engl J Med. 2015 Jan 22;372(4):331–340.

Published In

N Engl J Med

DOI

EISSN

1533-4406

Publication Date

January 22, 2015

Volume

372

Issue

4

Start / End Page

331 / 340

Location

United States

Related Subject Headings

  • United States
  • Risk Factors
  • Infant, Very Low Birth Weight
  • Infant, Premature, Diseases
  • Infant, Newborn
  • Infant, Extremely Premature
  • Infant Mortality
  • Infant
  • Humans
  • Gestational Age