| Autor: |
Mitsuhiro Haga, Masayo Kanai, Akio Ishiguro, Eri Nishimura, Yohei Minamitani, Ayaka Iwatani, Ryo Nishiguchi, Naoyuki Miyahara, Shuntaro Oka, Ayumi Sasaki, Yukiko Motojima, Kana Saito, Kanako Itoh, Sumiko Era, Shinichiro Yabe, Akihiko Kikuchi, Miharu Fuji, Mizue Matsumoto, Fumihiko Namba, Hisanori Sobajima, Masanori Tamura, Kazuhiko Kabe |
| Rok vydání: |
2022 |
| Předmět: |
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| Zdroj: |
The Journal of pediatrics. |
| ISSN: |
1097-6833 |
| Popis: |
To elucidate whether the survival and long-term neurodevelopmental outcomes of extremely preterm infants have improved in a Japanese tertiary center with an active treatment policy for infants born at 22-23 weeks of gestation.This single-centered retrospective cohort study enrolled EPI treated at Saitama Medical Center, Saitama Medical University, from 2003 to 2014. Patients with major congenital abnormalities were excluded. Primary outcomes were in-hospital survival and severe neurodevelopmental impairment (NDI) at six years of age, which was defined as having severe cerebral palsy, severe cognitive impairment, severe visual impairment, or deafness. We assessed the changes in primary outcomes between the first (Period 1; 2003-2008) and the second half (Period 2; 2009-2014) of the study period and evaluated the association between birth-year and primary outcomes using multivariate logistic regression models.Of the 403 eligible patients, 340 (84%) survived to discharge. Among 248 patients available at six years of age, 43 (14%) were classified as having severe NDI. Between the two periods, in-hospital survival improved from 155/198 (78%) to 185/205 (90%), but severe NDI increased from 11/108 (10%) to 32/140 (23%). In multivariate logistic regression models adjusted for gestational age, birthweight, sex, singleton birth, and antenatal corticosteroids, the adjusted odds ratio (95% confidence interval) of birth-year for in-hospital survival and severe NDI was 1.2 (1.1-1.3) and 1.1 (1.0-1.3), respectively.Mortality among EPI has improved over the past 12 years; nevertheless, no significant improvement was observed in the long-term neurodevelopmental outcomes. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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