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J Pediatr. 2016 Oct;177:144-152.e6. doi: 10.1016/j.jpeds.2016.04.083. Epub 2016 May 24.

Neonatal Outcomes of Very Low Birth Weight and Very Preterm Neonates: An International Comparison.

Collaborators (406)

Badawi N, Marshall P, Craven P, Simmer K, Stack J, Casalaz D, Carse E, Cooke L, Shingde V, Cartwright D, Hunt R, Kilburn C, Dargaville P, Lui K, Paradisis M, Rieger I, Kuschel C, Numa A, Carlisle H, Koh G, Andersen C, Luig M, Austin N, Broadbent R, Mildenhall L, Battin M, Bourchier D, Richardson V, Synnes A, Rouvinez-Bouali N, Piedboeuf B, Bulleid B, Yee W, Singhal N, Harrison A, Tan-Dy C, Shivananda S, Tan K, James A, Seshia M, Barrington K, Lefebvre F, McMillan D, Andrews W, Kovacs L, Dow K, Clarke M, Riley P, Shah P, Ohlsson A, Aziz K, Peliowski A, Cieslak Z, Sorokan T, Kalapesi Z, Ninan A, Sankaran K, Faucher D, Barrington K, Cronin G, Canning R, da Silva O, Lee D, Ojah C, Dunn M, Heymann E, Zangen S, Kushnir A, Mimouni F, Bader D, Rothschild A, Strauss Z, Felszer C, Jeryes J, Even Tov-Friedman S, Bar-Oz B, Feldman M, Saad N, Flidel-Rimon O, Weisbrod M, Lubin D, Litmanovitz I, Blazer S, Shinwell E, Sirota L, Nijim Y, Mimouni F, Golan A, Mandel D, Fleisher-Sheffer V, Kohelet D, Bakhrakh L, Hattori S, Konishi S, Amizuka T, Kasai T, Takahasi R, Arai H, Sato M, Miyazono Y, Shimizu J, Suzumura H, Kono Y, Inoue T, Miyabayashi H, Sobajima H, Ishiguro R, Sato H, Totsu S, Ishii N, Hosono S, Shiraishi M, Miura H, Nakao A, Yoda H, Shimizu M, Seki K, Itani Y, Suzuki K, Nemoto A, Nakamura T, Wada M, Nagayama Y, Numata O, Futatani T, Ueno Y, Iwai K, Kono Y, Ooki S, Nakazawa Y, Suzuki C, Tanaka T, Bonno M, Nakamura K, Kihara M, Sano H, Shiraishi A, Ohashi A, Ichiba H, Sumi K, Yoshimoto S, Takahashi Y, Okutani T, Miura M, Kato F, Watabe S, Kageyama M, Fukuhara R, Hayashitani M, Hasegawa K, Koyano K, Kobayashi S, Akiyoshi S, Nakata Y, Kanda T, Tadashi H, Kanda H, Nakamura M, Matsumoto N, Ochiai M, Aoki M, Kawase A, Iida K, Ishihara C, Kohama M, Seara MJF, Bermúdez JMF, Martínez Gutiérrez A, Martínez Ayúcar MM, Díaz CV, Quiles Durá JL, González Santacruz M, Siguile MAF, Fernández AR, Fernández Colomer B, García López E, Figuera Aloy J, Botet Mussons F, Anquela Sanz I, Galiana GG, Moliner Calderon E, Pujol AN, Vives AM, Iriondo Sanz M, Porta R, Cogul EC, Castells Vilella L, Álvarez BA, Montero Macarro JM, Barrio Sacristán AR, Cuesta MJL, Tardío O, Sánchez Puerta EV, Benavente Fernández I, Romero JM, Martinez Gimenez MD, Olmos RA, Segura RT, Cabañas JMG, Muñoz MDH, Trujillo A, Moltó Ripoll LF, Hurtado Suazo JA, Aldea Romero AE, Grisolía LP, Garrido Ocana AI, Soblechero EG, Ruiz Del Prado MY, Díez IE, González-Luis GE, García-Muñoz Rodrigo F, Iglesias EÁ, Calvo FF, Solé Mir E, Martí JG, Ortiz Movilla R, Vilaplana LC, San Miguel MG, Martín IL, Díaz MF, Pérez Rodríguez J, Salas S, Labian CM, González Armengod C, Comeche LD, Sánchez Tamayo T, García Del Río M, Alonso Gallego JÁ, Lloreda Garcia JM, González JV, Ocampo, Insunza NB, García González P, Granero Asencio M, Sanz AL, Díaz CM, Ferrari Cortés A, Fuster Jorge PA, López Mendoza S, Ramírez SR, Font MDMA, de Ureta Huertas A, Plana AA, Capell JE, Roqués V, Morcillo F, Marín S, Omaña MF, Iturriaga GS, Kofron J, Brodd KS, Odlind A, Alberg L, Arwehed S, Engström E, Kasemo A, Ekelund C, Åhman L, Ingemarsson F, Österdahl L, Thurn P, Albinsson E, Selander B, Lundberg F, Heimdahl I, Hafström O, Wejryd E, Kuusima-Löfbom J, Lund EE, Thorén A, Hallberg B, Broström EB, Hertzberg T, Stjernstedt B, Robinson J, Farooqi A, Normann E, Fredriksson M, Palm A, Hedblom Å, Sjöberg K, Thorbjörnsson L, Ohlin A, Florell R, Smedsaas-Löfvenberg A, Meyer P, Anderegg C, Schulzke S, Nelle M, Wagner B, Bär W, Kaczala G, Pfister RE, Tolsa JF, Roth M, Berger TM, Laubscher B, Malzacher A, Micallef JP, Hegi L, Bassler D, Arlettaz R, Bernet V, Bag S, Kefas J, Rackham O, Thirumurgan A, Yoxall B, McBride T, Webb D, Amegavie L, Hassan A, Ambadkar P, Dyke M, Babiker S, Rubin S, Ogilvy-Stuart A, Panasa N, Settle P, Moise J, Edi-Osagie N, Heal C, Birch J, Hasib A, Soe A, Kumar N, Kisat H, Vasu V, Lama M, Gupta R, Rawlingson C, Wickham T, Schwarz K, Sommen V, Watkin S, Gupta A, Aladangady N, Ali I, Alsford L, Mannan K, Rainer E, Wilson N, Thomas M, Mathur R, Cruwys M, Godambe S, Godambe S, Watts T, Kuna J, Chang J, Filkin J, Huddy C, Shephard R, Zieba K, Rao P, Currie A, Currie A, Manzoor A, Ahmed M, Simmons P, Nycyk J, Simmons P, Gallagher A, Halahakoon C, Deshpande S, Mohite A, Palmer K, Gibson A, Garbash M, Lal M, Abu-Harb M, Garbash M, McKeon-Carter R, Selter M, Munyard P, Lewis V, Raman M, Whincup G, Mallik A, Amess P, Godden C, Amess P, Reynolds P, Misra I, Shettihalli N, De Halpert P, Salgia S, Sanghavi R, Wigfield R, Deketelaere A, Khashu M, Hall M, Groves C, Brown N, Brennan N, Vamvakiti K, Ratnayaka M, Pirie S, Jones S, Mannix P, Harding D, Eaton M, Schwarz K, Gibson D, Miall L, Gibson D.

Author information

1
Canadian Neonatal Network, Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada. Electronic address: pshah@mtsinai.on.ca.
2
Australian and New Zealand Neonatal Network, Royal Hospital for Women, National Perinatal Epidemiology and Statistic Unit, University of New South Wales, Randwick, Australia.
3
Swedish Neonatal Quality Register, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
4
Canadian Neonatal Network, Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada.
5
Israel Neonatal Network, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Centre, Tel Hashomer, Israel.
6
Swiss Neonatal Network, Department of Neonatology, University Hospital Zurich, University of Zurich, Zürich, Switzerland.
7
UK Neonatal Collaborative, Neonatal Data Analysis Unit, Section of Neonatal Medicine, Department of Medicine, Imperial College London, Chelsea and Westminster Hospital campus, London, United Kingdom.
8
Australia and New Zealand Neonatal Network, Department of Pediatrics, University of Otago, Christchurch, New Zealand.
9
Neonatal Research Network Japan, Maternal and Perinatal Center, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan.
10
Spanish Neonatal Network, Hospital Universitario de Salamanca, Salamanca, Spain.
11
Swedish Neonatal Quality Register, Department of Pediatrics/Neonatal Services, Umeå University Hospital, Umeå, Sweden.
12
Neonatal Research Network Japan, Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan.
13
Spanish Neonatal Network, Hospital Clinic, Barcelona, Spain.

Abstract

OBJECTIVE:

To compare rates of a composite outcome of mortality or major morbidity in very-preterm/very low birth weight infants between 8 members of the International Network for Evaluating Outcomes.

STUDY DESIGN:

We included 58 004 infants born weighing <1500 g at 24(0)-31(6) weeks' gestation from databases in Australia/New Zealand, Canada, Israel, Japan, Spain, Sweden, Switzerland, and the United Kingdom. We compared a composite outcome (mortality or any of grade ≥3 peri-intraventricular hemorrhage, periventricular echodensity/echolucency, bronchopulmonary dysplasia, or treated retinopathy of prematurity) between each country and all others by using standardized ratios and pairwise using logistic regression analyses.

RESULTS:

Despite differences in population coverage, included neonates were similar at baseline. Composite outcome rates varied from 26% to 42%. The overall mortality rate before discharge was 10% (range: 5% [Japan]-17% [Spain]). The standardized ratio (99% CIs) estimates for the composite outcome were significantly greater for Spain 1.09 (1.04-1.14) and the United Kingdom 1.16 (1.11-1.21), lower for Australia/New Zealand 0.93 (0.89-0.97), Japan 0.89 (0.86-0.93), Sweden 0.81 (0.73-0.90), and Switzerland 0.77 (0.69-0.87), and nonsignificant for Canada 1.04 (0.99-1.09) and Israel 1.00 (0.93-1.07). The adjusted odds of the composite outcome varied significantly in pairwise comparisons.

CONCLUSIONS:

We identified marked variations in neonatal outcomes between countries. Further collaboration and exploration is needed to reduce variations in population coverage, data collection, and case definitions. The goal would be to identify care practices and health care organizational factors, which has the potential to improve neonatal outcomes.

KEYWORDS:

bronchopulmonary dysplasia; composite outcome; peri-intraventricular hemorrhage; periventricular echodensity/echolucency; preterm birth; quality improvement; retinopathy of prematurity

PMID:
27233521
DOI:
10.1016/j.jpeds.2016.04.083
[Indexed for MEDLINE]

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