A recent study (Patel RM et al. NEJM 2015; 372: 331-40) provides prospectively collected data on 6075 deaths among 22,248 live births with gestational ages 22-29 weeks from the U.S NICHD Neonatal Research Network. between 2000 thru 2011:
- Improved death rate in most recent period of study: number of deaths per 1000 live births was 275 (2000-2003), 285 (2004-2007), 258 (2008-2011)
- While there were fewer pulmonary deaths with time, the deaths attributed to necrotizing enterocolitis increased: number of deaths per 1000 live births was 23 (2000-2003), 29 (2004-2007), 30 (2008-2011). Necrotizing enterocolitis was the leading cause of death between 15-60 days of life (Figure 1).
- Overall, 40.4% of deaths occurred within 12 hours after birth. Only 17.3% occurred after 28 days of life.
- For the entire study period, the rate of death (per thousand) was associated with gestational age: 949 (22 weeks), 730 (23 weeks), 427 (24 weeks), 258 (25 weeks), 157 (26 weeks), 115 (27 weeks), 78 (28 weeks)
- The authors speculate that the overall reduction in death rate is likely related to more aggressive respiratory care (for bronchopulmonary dysplasia); one marker of this was increased usage of high-frequency ventilation.
Bottomline: While there has been improvement, being born premature is associated with high mortality.
- Related blog posts:
- Neonatal Nutrition Lecture -What We Know Right Now …
- Probiotics For NEC -More Work is Needed (part 1 …