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Single-centre vs. population-based outcome data of extremely preterm infants at the limits of viability

Authors

  • Patrizia Kutz,

    1. Department of Neonatology and Paediatric Intensive Care, Vest Children’s Hospital, University Witten-Herdecke, Datteln, Germany
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  • Sandra Horsch,

    1. Department of Neonatology, Erasmus MC-Sophia Children’s Hospital, Rotterdam, The Netherlands
    2. CLINTEC, Karolinska University Hospital, Stockholm, Sweden
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  • Lisa Kühn,

    1. Department of Paediatrics I, University Children’s Hospital, Essen, Germany
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  • Claudia Roll

    1. Department of Neonatology and Paediatric Intensive Care, Vest Children’s Hospital, University Witten-Herdecke, Datteln, Germany
    2. Department of Paediatrics I, University Children’s Hospital, Essen, Germany
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PD Dr Claudia Roll, Abt. für Neonatologie und Pädiatrische Intensivmedizin, Vestische Kinder- und Jugendklinik, Universität Witten-Herdecke, Dr-Friedrich-Steiner-Str. 5, D-45711 Datteln, Germany.
Tel: +49-2363-975852 |
Fax: +49-2363-975219 |
Email: claudia.roll@kinderklinik-datteln.de

Abstract

Aim:  In response to the disappointing outcome data of the population-based EPICure study published in 2000, we compared the outcome of infants 22 0/7 to 25 6/7 weeks of gestational age (GA) in a single tertiary care centre 2000–2004 with that of EPICure.

Methods:  EPICure tools and definitions, including 30 months’ Bayley Scales.

Results:  Of 83 infants <26 weeks born alive, more were admitted to intensive care – 82% vs. 68% (p 0.0001) – and more infants survived to discharge (57% vs. 26%, p < 0.0001; 69% vs. 39%, p 0.01, of those admitted to intensive care). More infants, as a percentage of live births, survived without severe (41%, 34/83 vs. 20%, 233/1185, p < 0.0001) or overall disability (22%, 18/83 vs. 13%, 155/1185, p 0.03). However, at the border of viability – GA 23 and 24 weeks – the rate of infants surviving without overall disability was not significantly higher (13%, 6/45 vs. 9%, 56/623).

Conclusion:  In infants <26 weeks of GA, increased rates of survival and survival without disability were observed in a single-centre inborn cohort born 5–8 years later than the EPICure cohort. This did not translate into increased survival without overall disability in infants of 23–24 weeks of GA.

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