Neonatal Outcomes of Very Low Birth Weight and Very Preterm Neonates: An International Comparison - 23/09/16
Doi : 10.1016/j.jpeds.2016.04.083
Prakesh S. Shah, MD 1, ⁎ 
, Kei Lui, MD 2, Gunnar Sjörs, MD 3, Lucia Mirea, PhD 1, ∗, Brian Reichman, MBChB 4, Mark Adams, MSc 5, Neena Modi, MD 6, Brian A. Darlow, MD 7, Satoshi Kusuda, MD 8, Laura San Feliciano, MD 9, Junmin Yang, MSc 1, Stellan Håkansson, MD 10, Rintaro Mori, MD 11, Dirk Bassler, MD 5, Josep Figueras-Aloy, PhD 12, Shoo K. Lee, MBBS 1
for the investigators of the
, Kei Lui, MD 2, Gunnar Sjörs, MD 3, Lucia Mirea, PhD 1, ∗, Brian Reichman, MBChB 4, Mark Adams, MSc 5, Neena Modi, MD 6, Brian A. Darlow, MD 7, Satoshi Kusuda, MD 8, Laura San Feliciano, MD 9, Junmin Yang, MSc 1, Stellan Håkansson, MD 10, Rintaro Mori, MD 11, Dirk Bassler, MD 5, Josep Figueras-Aloy, PhD 12, Shoo K. Lee, MBBS 1for the investigators of the
International Network for Evaluating Outcomes (iNeo) of Neonates†
Nadia Badawi, MD, Peter Marshall, MD, Paul Craven, MD, Karen Simmer, MD, Jacqueline Stack, MD, Dan Casalaz, MD, Elizabeth Carse, MD, Lucy Cooke, MD, Vijay Shingde, MD, David Cartwright, MD, Rod Hunt, MD, Charles Kilburn, MD, Peter Dargaville, MD, Kei Lui, MD, Mary Paradisis, MD, Ingrid Rieger, MD, Carl Kuschel, MD, Andrew Numa, MD, Hazel Carlisle, MD, Guan Koh, MD, Chad Andersen, MD, Melissa Luig, MD, Nicola Austin, MD, Roland Broadbent, MD, Lindsay Mildenhall, MD, Malcolm Battin, MD, David Bourchier, MD, Vaughan Richardson, MD, Anne Synnes, MD, Nicole Rouvinez-Bouali, MD, Bruno Piedboeuf, MD, Barbara Bulleid, MD, Wendy Yee, MD, Nalini Singhal, MD, Adele Harrison, MD, Cherrie Tan-Dy, MD, Sandesh Shivananda, MD, Kenneth Tan, MD, Andrew James, MD, Molly Seshia, MD, Keith Barrington, MD, Francine Lefebvre, MD, Doug McMillan, MD, Wayne Andrews, MD, Lajos Kovacs, MD, Kimberly Dow, MD, Maxine Clarke, MD, Patricia Riley, MD, Prakesh Shah, MD, Arne Ohlsson, MD, Khalid Aziz, MD, Abraham Peliowski, MD, Zenon Cieslak, MD, Todd Sorokan, MD, Zarin Kalapesi, MD, Abraham Ninan, MD, Koravangattu Sankaran, MD, Daniel Faucher, MD, Keith Barrington, MD, Gerarda Cronin, MD, Roderick Canning, MD, Orlando da Silva, MD, David Lee, MD, Cecil Ojah, MD, Michael Dunn, MD, Eli Heymann, MD, Shmuel Zangen, MD, Amir Kushnir, MD, Francis Mimouni, MD, David Bader, MD, Avi Rothschild, MD, Zipora Strauss, Clari Felszer, MD, Jamalia Jeryes, MD, Smadar Even Tov-Friedman, MD, Benjamin Bar-Oz, MD, Michael Feldman, MD, Nizar Saad, MD, Orna Flidel-Rimon, MD, Meir Weisbrod, MD, Daniel Lubin, MD, Ita Litmanovitz, MD, Shraga Blazer, MD, Eric Shinwell, MD, Leah Sirota, MD, Yousif Nijim, MD, Francis Mimouni, MD, Agneta Golan, MD, Dror Mandel, MD, Vered Fleisher-Sheffer, MD, David Kohelet, MD, Lev Bakhrakh, MD, Satoshi Hattori, MD, Shohei Konishi, MD, Takasuke Amizuka, MD, Takeo Kasai, MD, Ritsuko Takahasi, MD, Hirokazu Arai, MD, Maki Sato, MD, Yayoi Miyazono, MD, Junichi Shimizu, MD, Hiroshi Suzumura, MD, Yumi Kono, MD, Takahiro Inoue, MD, Hiroshi Miyabayashi, MD, Hisanori Sobajima, Rika Ishiguro, Hiroyuki Sato, MD, Satsuki Totsu, MD, Nozomi Ishii, MD, Shigeharu Hosono, MD, Mika Shiraishi, MD, Humihiro Miura, MD, Atsushi Nakao, MD, Hitoshi Yoda, MD, Mitsumasa Shimizu, MD, Kazuo Seki, MD, Yasuhumi Itani, MD, Keiji Suzuki, MD, Atsushi Nemoto, MD, Tomohiko Nakamura, MD, Masaki Wada, MD, Yoshihisa Nagayama, MD, Osamu Numata, MD, Takeshi Futatani, MD, Yasuhisa Ueno, MD, Kazuyuki Iwai, MD, Yoshinori Kono, MD, Shigeru Ooki, MD, Yusuke Nakazawa, MD, Chizuko Suzuki, MD, Taihei Tanaka, MD, Motoki Bonno, MD, Kenji Nakamura, MD, Minako Kihara, MD, Hiroyuki Sano, MD, Atsushi Shiraishi, MD, Atsushi Ohashi, MD, Hiroyuki Ichiba, MD, Kiyoaki Sumi, MD, Seiji Yoshimoto, MD, Yukihiro Takahashi, MD, Takahiro Okutani, MD, Masumi Miura, MD, Fumihide Kato, MD, Shinichi Watabe, MD, Misao Kageyama, MD, Rie Fukuhara, MD, Michiko Hayashitani, MD, Keiko Hasegawa, MD, Kosuke Koyano, MD, Shoko Kobayashi, MD, Shinosuke Akiyoshi, MD, Yusei Nakata, MD, Takeshi Kanda, MD, Hisano Tadashi, MD, Hiroshi Kanda, MD, Masaki Nakamura, Naoko Matsumoto, MD, Masayuki Ochiai, MD, Mikihiro Aoki, MD, Akihiko Kawase, MD, Koichi Iida, MD, Chie Ishihara, MD, Moriyasu Kohama, MD, Ma José Fernández Seara, MD, José Ma Fraga Bermúdez, MD, Andrés Martínez Gutiérrez, MD, María Mercedes Martínez Ayúcar, MD, Carolina Vizcaíno Díaz, MD, José Luis Quiles Durá, MD, María González Santacruz, MD, Ma Anne Feret Siguile, MD, Adela Rodríguez Fernández, MD, Belén Fernández Colomer, MD, Enrique García López, MD, Josep Figuera Aloy, MD, Francesc Botet Mussons, MD, Israel Anquela Sanz, MD, Gemma Ginovart Galiana, MD, Elisenda Moliner Calderon, MD, Antonio Natal Pujol, MD, Alicia Mirada Vives, MD, Martín Iriondo Sanz, MD, Roser Porta, MD, Eva Capdevila Cogul, MD, Laura Castells Vilella, MD, Bruno Alonso Álvarez, MD, José María Montero Macarro, MD, Ana R. Barrio Sacristán, MD, Ma Jesús López Cuesta, MD, Ortiz Tardío, MD, Eugenia Valls Sánchez Puerta, MD, Isabel Benavente Fernández, MD, Juan Mena Romero, MD, María Dolores Martinez Gimenez, MD, Ramón Aguilera Olmos, MD, Ricardo Tosca Segura, MD, Juana Ma Guzmán Cabañas, MD, Ma Dolores Huertas Muñoz, MD, Alberto Trujillo, MD, Luis Fidel Moltó Ripoll, MD, José Antonio Hurtado Suazo, MD, Ana Elena Aldea Romero, MD, Luis Paisán Grisolía, MD, Ana Isabel Garrido Ocana, MD, Eduardo Garcia Soblechero, MD, Ma Yolanda Ruiz del Prado, MD, Inés Esteba Díez, MD, Gema E. González-Luis, MD, Fermín García-Muñoz Rodrigo, MD, Emilio Álvaro Iglesias, MD, Fernando Fernandez Calvo, MD, Eduard Solé Mir, MD, Jordi Garcia Martí, MD, Roberto Ortiz Movilla, MD, Lucía Cabanillas Vilaplana, MD, Marta García San Miguel, MD, Isabel Llana Martín, MD, María Fernández Díaz, MD, Jesús Pérez Rodríguez, MD, Sofía Salas, MD, Carmen Muñoz Labian, MD, Carmen González Armengod, MD, Laura Domingo Comeche, MD, Tomás Sánchez Tamayo, MD, Manuel García del Río, MD, José Ángel Alonso Gallego, MD, José María Lloreda Garcia, MD, Javier Vilas González, MD, Ocampo, MD, Nieves Balado Insunza, MD, Pilar García González, MD, Mercedes Granero Asencio, MD, Antonia López Sanz, MD, Carmen Macías Díaz, MD, Araceli Ferrari Cortés, MD, Pedro Amadeo Fuster Jorge, MD, Santiago López Mendoza, MD, Sabina Romero Ramírez, MD, Ma del Mar Albújar Font, MD, Alicia de Ureta Huertas, MD, Antonio Arroyos Plana, MD, Javier Estañ Capell, MD, Vicente Roqués, MD, F. Morcillo, MD, Sara Marín, MD, María Fernanda Omaña, MD, Gabriel Saitua Iturriaga, MD, Jiri Kofron, MD, Katarina Strand Brodd, MD, Andreas Odlind, MD, Lars Alberg, MD, Sofia Arwehed, MD, Eva Engström, MD, Anna Kasemo, MD, Charlotte Ekelund, MD, Lars Åhman, MD, Fredrik Ingemarsson, MD, Laura Österdahl, MD, Pernilla Thurn, MD, Eva Albinsson, MD, Bo Selander, MD, Fredrik Lundberg, MD, Ingela Heimdahl, MD, Ola Hafström, MD, Erik Wejryd, MD, Johanna Kuusima-Löfbom, MD, Ellen-Elisabeth Lund, MD, Annelie Thorén, MD, Boubou Hallberg, MD, Eva Berggren Broström, MD, Torbjörn Hertzberg, MD, Björn Stjernstedt, MD, Johan Robinson, MD, Aijaz Farooqi, MD, Erik Normann, MD, Magnus Fredriksson, MD, Anders Palm, MD, Åsa Hedblom, MD, Kenneth Sjöberg, MD, Leif Thorbjörnsson, MD, Andreas Ohlin, MD, Rein Florell, MD, Agneta Smedsaas-Löfvenberg, MD, Philipp Meyer, MD, Claudia Anderegg, MD, Sven Schulzke, MD, Mathias Nelle, MD, Bendicht Wagner, MD, Walter Bär, MD, Grégoire Kaczala, MD, Riccardo E. Pfister, MD, Jean-François Tolsa, MD, Matthias Roth, MD, Thomas M. Berger, MD, Bernhard Laubscher, MD, Andreas Malzacher, MD, John P. Micallef, MD, Lukas Hegi, MD, Dirk Bassler, MD, Romaine Arlettaz, MD, Vera Bernet, MD, Santanu Bag, MD, Jonathan Kefas, MD, Oliver Rackham, MD, Arumugavelu Thirumurgan, MD, Bill Yoxall, MD, Tim McBride, MD, Delyth Webb, MD, Laweh Amegavie, MD, Ahmed Hassan, MD, Priyadarshan Ambadkar, MD, Mark Dyke, MD, Seif Babiker, MD, Susan Rubin, MD, Amanda Ogilvy-Stuart, MD, Nagesh Panasa, MD, Paul Settle, MD, Jonathan Moise, MD, Ngozi Edi-Osagie, MD, Carrie Heal, MD, Jacqeline Birch, MD, Abdul Hasib, MD, Aung Soe, MD, Niraj Kumar, MD, Hamudi Kisat, MD, Vimal Vasu, MD, Meera Lama, MD, Richa Gupta, MD, Chris Rawlingson, MD, Tim Wickham, MD, Karin Schwarz, MD, Van Sommen, MD, Sara Watkin, MD, Aashish Gupta, MD, Narendra Aladangady, MD, Imdad Ali, MD, Lesley Alsford, MD, Khalid Mannan, MD, Ebel Rainer, MD, Nicholas Wilson, MD, Mark Thomas, MD, Ramnik Mathur, MD, Michele Cruwys, MD, Sunit Godambe, MD, Sunit Godambe, MD, Timothy Watts, MD, Jauro Kuna, MD, John Chang, MD, Jon Filkin, MD, Charlotte Huddy, MD, Ruth Shephard, MD, Krzystof Zieba, MD, Patti Rao, MD, Andrew Currie, MD, Andrew Currie, MD, Azhar Manzoor, MD, Munir Ahmed, MD, Phil Simmons, MD, Julie Nycyk, MD, Phil Simmons, MD, Andrew Gallagher, MD, Chrisantha Halahakoon, MD, Sanjeev Deshpande, MD, Anand Mohite, MD, Kate Palmer, MD, Alan Gibson, MD, Mehdi Garbash, MD, Mithilesh Lal, MD, Majd Abu-Harb, MD, Mehdi Garbash, MD, Róisín McKeon-Carter, MD, Michael Selter, MD, Paul Munyard, MD, Vaughan Lewis, MD, Mala Raman, MD, Graham Whincup, MD, Abdus Mallik, MD, Philip Amess, MD, Charles Godden, MD, Philip Amess, MD, Peter Reynolds, MD, Indranil Misra, MD, Naveen Shettihalli, MD, Peter De Halpert, MD, Sanjay Salgia, MD, Rekha Sanghavi, MD, Ruth Wigfield, MD, Abby Deketelaere, MD, Minesh Khashu, MD, Michael Hall, MD, Charlotte Groves, MD, Nick Brown, MD, Nick Brennan, MD, Katia Vamvakiti, MD, Mal Ratnayaka, MD, Simon Pirie, MD, Stephen Jones, MD, Paul Mannix, MD, David Harding, MD, Megan Eaton, MD, Karin Schwarz, MD, David Gibson, MD
Lawrence Miall, MD, David Gibson, MD
Lawrence Miall, MD, David Gibson, MD
1 Canadian Neonatal Network, Maternal-Infant Care Research Centre, Mount Sinai Hospital, Toronto, Ontario, Canada
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 Israel Neonatal Network, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Centre, Tel Hashomer, Israel
5 Swiss Neonatal Network, Department of Neonatology, University Hospital Zurich, University of Zurich, Zürich, Switzerland
6 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
7 Australia and New Zealand Neonatal Network, Department of Pediatrics, University of Otago, Christchurch, New Zealand
8 Neonatal Research Network Japan, Maternal and Perinatal Center, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan
9 Spanish Neonatal Network, Hospital Universitario de Salamanca, Salamanca, Spain
10 Swedish Neonatal Quality Register, Department of Pediatrics/Neonatal Services, Umeå University Hospital, Umeå, Sweden
11 Neonatal Research Network Japan, Department of Health Policy, National Center for Child Health and Development, Tokyo, Japan
12 Spanish Neonatal Network, Hospital Clinic, Barcelona, Spain
∗Reprint requests: Prakesh S. Shah, MD, Professor, Department of Paediatrics, Mount Sinai Hospital, Rm 19-231F, 600 University Ave, Toronto, Ontario, Canada M5G 1X5.Department of PaediatricsMount Sinai HospitalRm 19-231F, 600 University AveTorontoOntarioM5G 1X5Canada
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 240–316 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.
Le texte complet de cet article est disponible en PDF.Keywords : bronchopulmonary dysplasia, composite outcome, peri-intraventricular hemorrhage, periventricular echodensity/echolucency, preterm birth, quality improvement, retinopathy of prematurity
Abbreviations : iNeo, NEC, SR, UKNC
Plan
| Funding for iNeo of Neonates has been provided by a Canadian Institutes of Health Research (FRN87518) Chair in Reproductive and Child Health Services and Policy Research (to P.S.). Additional funding is available at www.jpeds.com (Appendix 2). The authors declare no conflicts of interest. |
© 2016
Elsevier Inc. Tous droits réservés.
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