Volume of neonatal care and survival without ...
Type de document :
Article dans une revue scientifique: Article original
PMID :
URL permanente :
Titre :
Volume of neonatal care and survival without disability at 2�years in very preterm infants: results of a french national cohort study
Auteur(s) :
Desplanches, Thomas [Auteur]
Blondel, Béatrice [Auteur]
Morgan, Andrei Scott [Auteur]
Burguet, Antoine [Auteur]
Kaminski, Monique [Auteur]
Lecomte, Benedicte [Auteur]
Marchand-Martin, Laetitia [Auteur]
Roze, Jean-Christophe [Auteur]
Sagot, Paul [Auteur]
Truffert, Patrick [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Zeitlin, Jennifer [Auteur]
Ancel, Pierre-Yves [Auteur]
Fresson, Jeanne [Auteur]
Blondel, Béatrice [Auteur]
Morgan, Andrei Scott [Auteur]
Burguet, Antoine [Auteur]
Kaminski, Monique [Auteur]
Lecomte, Benedicte [Auteur]
Marchand-Martin, Laetitia [Auteur]
Roze, Jean-Christophe [Auteur]
Sagot, Paul [Auteur]
Truffert, Patrick [Auteur]
METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Zeitlin, Jennifer [Auteur]
Ancel, Pierre-Yves [Auteur]
Fresson, Jeanne [Auteur]
Titre de la revue :
The Journal of pediatrics
Nom court de la revue :
J. Pediatr.
Date de publication :
2019-07-04
ISSN :
1097-6833
Discipline(s) HAL :
Sciences du Vivant [q-bio]
Résumé en anglais : [en]
OBJECTIVE: To investigate the relation between neonatal intensive care unit (NICU) volume and survival, and neuromotor and sensory disabilities at 2 years in very preterm infants.
METHODS: The EPIPAGE-2 (Etude Epidémiologique ...
Lire la suite >OBJECTIVE: To investigate the relation between neonatal intensive care unit (NICU) volume and survival, and neuromotor and sensory disabilities at 2 years in very preterm infants. METHODS: The EPIPAGE-2 (Etude Epidémiologique sur les Petits Âges Gestationnels-2) national prospective population-based cohort study was used to include 2447 babies born alive in 66 level III hospitals between 24 and 30 completed weeks of gestation in 2011. The outcome was survival without disabilities (levels 2-5 of the Gross Motor Function Classification System for cerebral palsy with or without unilateral or bilateral blindness or deafness). Units were grouped in quartiles according to volume, defined as the annual admissions of very preterm babies. Multivariate logistic regression analyses with population average models were used. RESULTS: Survival at discharge was lower in hospitals with lower volumes of neonatal activity (aOR 0.55, 95% CI 0.33-0.91). Survival without neuromotor and sensory disabilities at 2 years increased with hospital volume, from 75% to 80.7% in the highest volume units. After adjustment for gestational age, small for gestational age, sex, maternal age, infertility treatment, multiple pregnancy, principal cause of prematurity, parental socioeconomic status, and mother's country of birth, survival without neuromotor or sensory disabilities was significantly lower in hospitals with a lower volume of neonatal activity (aOR 0.60, 95% CI 0.38-0.95) than in the highest quartile hospitals. CONCLUSIONS: These results suggest that lower neonatal intensive care unit volume is associated with lower survival without an increase in disabilities at 2 years. These results could be useful to generate improvements of perinatal regionalization.Lire moins >
Lire la suite >OBJECTIVE: To investigate the relation between neonatal intensive care unit (NICU) volume and survival, and neuromotor and sensory disabilities at 2 years in very preterm infants. METHODS: The EPIPAGE-2 (Etude Epidémiologique sur les Petits Âges Gestationnels-2) national prospective population-based cohort study was used to include 2447 babies born alive in 66 level III hospitals between 24 and 30 completed weeks of gestation in 2011. The outcome was survival without disabilities (levels 2-5 of the Gross Motor Function Classification System for cerebral palsy with or without unilateral or bilateral blindness or deafness). Units were grouped in quartiles according to volume, defined as the annual admissions of very preterm babies. Multivariate logistic regression analyses with population average models were used. RESULTS: Survival at discharge was lower in hospitals with lower volumes of neonatal activity (aOR 0.55, 95% CI 0.33-0.91). Survival without neuromotor and sensory disabilities at 2 years increased with hospital volume, from 75% to 80.7% in the highest volume units. After adjustment for gestational age, small for gestational age, sex, maternal age, infertility treatment, multiple pregnancy, principal cause of prematurity, parental socioeconomic status, and mother's country of birth, survival without neuromotor or sensory disabilities was significantly lower in hospitals with a lower volume of neonatal activity (aOR 0.60, 95% CI 0.38-0.95) than in the highest quartile hospitals. CONCLUSIONS: These results suggest that lower neonatal intensive care unit volume is associated with lower survival without an increase in disabilities at 2 years. These results could be useful to generate improvements of perinatal regionalization.Lire moins >
Langue :
Anglais
Audience :
Internationale
Vulgarisation :
Non
Établissement(s) :
CHU Lille
Université de Lille
Université de Lille
Date de dépôt :
2019-12-09T16:50:06Z