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Trends in Overall Mortality, and Timing and Cause of Death among Extremely Preterm Infants near the Limit of Viability

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Affiliated Author(s)
박재현
Alternative Author(s)
Park, Jae Hyun
Journal Title
PloS One
ISSN
1932-6203
Issued Date
2017
Abstract
Objective;
To investigate the trends in mortality, as well as in the timing and cause of death, among
extremely preterm infants at the limit of viability, and thus to identify the clinical factors that
contribute to decreased mortality.
Methods;
We retrospectively reviewed the medical records of 382 infants born at 23±26 weeks' gestation;
124 of the infants were born between 2001 and 2005 (period I) and 258 were born
between 2006 and 2011 (period II). We stratified the infants into two subgroups±ª23±24
weeksº and ª25±26 weeksº±and retrospectively analyzed the clinical characteristics and mortality
in each group, as well as the timing and cause of death. Univariate and multivariate logistic
regression analyses were done to identify the clinical factors associated with mortality.
Results;
The overall mortality rate in period II was 16.7% (43/258), which was significantly lower than
that in period I (30.6%; 38/124). For overall cause of death, there were significantly fewer
deaths due to sepsis (2.4% [6/258] vs. 8.1% [10/124], respectively) and air-leak syndrome
(0.8% [2/258] vs. 4.8% (6/124), respectively) during period II than during period I. Among
the clinical factors of time period, 1-and 5-min Apgar score, antenatal steroid identified significant
by univariate analyses. 5-min Apgar score and antenatal steroid use were significantly
associated with mortality in multivariate analyses.
Conclusion;
Improved mortality rate attributable to fewer deaths due to sepsis and air leak syndrome in
the infants with 23±26 weeks' gestation was associated with higher 5-minute Apgar score
and more antenatal steroid use.
Department
Dept. of Pediatrics (소아청소년학)
Publisher
School of Medicine
Citation
Jae Hyun Park et al. (2017). Trends in Overall Mortality, and Timing and Cause of Death among Extremely Preterm Infants near the Limit of Viability. PloS One, 12(1), e0170220–e0170220. doi: 10.1371/journal.pone.0170220
Type
Article
ISSN
1932-6203
DOI
10.1371/journal.pone.0170220
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32550
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Pediatrics (소아청소년학)
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