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Scientific Reports, 2019. 9(1), 7371-, DOI: https://doi.org/10.1038/s41598-019-43879-z
Mortality rate-dependent variations in the survival without major morbidities rate of extremely preterm infants
Jin Kyu Kim, Yun Sil Chang;Sein Jung;Won Soon Park
The effects of improved survival of EPT infants on morbidity among survivors remain largelycontroversial. This retrospective cohort study of the Korean Neonatal Network data investigatedwhether the mortality rate of 23–24 weeks’ gestation was associated with survival without majormorbidities in periviable 25–26 weeks’ gestation infants. The 2,083 eligible infants with 23–26 weeks’gestation were grouped based on institutional mortality rate (group 1 and 2 ≤50% and >50%mortality rate, respectively, for 23–24 weeks’ gestation) and were further divided into 23–24 and 25–26weeks’ gestation subgroups. The mortality rate of 23–24 weeks’ gestation infants was significantlylower in group 1 (32.7%) than in group 2 (69.9%). The survival without major morbidities rate for25–26 weeks’ gestation infants was significantly higher in group 1 (31.2%) than in group 2 (18.5%).Antenatal steroid use and Apgar score at 5 min in group 1 were associated with decreased mortalityand survival without major morbidities in 23–24 and 25–26 weeks’ gestation infants, respectively. Inthe multivariate analyses, decreased mortality rates in 23–24 weeks’ gestation infants were associatedwith higher survival without major morbidities rates in 25–26 weeks’ gestation infants due to decreasedbronchopulmonary dysplasia, periventricular leukomalacia, and late-onset sepsis. Evidence-basedperinatal and neonatal practices, including antenatal steroid use and better delivery room carecontributing to decreased mortality in periviable 23–24 weeks’ gestation infants, were associated withlower morbidity and higher survival without major morbidities in more mature 25–26 weeks’ gestationinfants.
- DOI: https://doi.org/10.1038/s41598-019-43879-z
- ISBN or ISSN: 2045-2322
- 본 연구는 질병관리본부 연구개발과제연구비를 지원받아 수행되었습니다.
- This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.