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Am J Perinatol 2022; 39(13): 1449-1459
DOI: 10.1055/s-0040-1722654
Original Article

Mortality and Morbidity in Premature Infants: An East and West Comparative Study

Monika Patil
1   Department of Pediatrics, Section of Neonatology, Texas Children's Hospital, Houston, Texas
2   Department of Pediatrics, Baylor College of Medicine, Houston, Texas
,
Venkateshwarlu Vardhelli
3   Department of Neonatology, Fernandez Hospital, Hyderabad, Telangana, India
,
Joseph L. Hagan
1   Department of Pediatrics, Section of Neonatology, Texas Children's Hospital, Houston, Texas
,
Saikiran Deshabhotla
3   Department of Neonatology, Fernandez Hospital, Hyderabad, Telangana, India
,
Srinivas Murki
3   Department of Neonatology, Fernandez Hospital, Hyderabad, Telangana, India
› Institutsangaben Funding None.
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Abstract

Objective Survival of preterm infants differs dramatically depending on birthplace. No previous studies have compared outcomes of preterm infants between low middle-income and high-income countries such as India and the United States. The purpose of this study is to evaluate differences in care practices, resources, mortality, and morbidities in preterm infants with birth weight 700 to 1,500 g between two major neonatal centers in these countries.

Study Design This is a retrospective cohort study with de-identified data from Fernandez Hospital (FH) in Hyderabad, India, and Texas Children's Hospital (TCH) in Houston, TX, for infants born January 2016 to December 2018, and weighing 700 to 1,500 g at birth. The primary outcome was death before hospital discharge.

Results Of 1,195 infants, 736 were admitted to FH and 459 were admitted to TCH. After controlling for differences in gestational age, small for gestational age, and antenatal corticosteroid use, TCH patients had lower mortality before hospital discharge (adjusted odds ratio [aOR] = 0.28, 95% confidence interval [CI]: 0.16–0.48, p < 0.001) and more bronchopulmonary dysplasia (BPD; aOR = 2.2, 95% CI: 1.51–3.21, p < 0.001). The composite outcome of death or BPD and death or any major morbidity (BPD or intraventricular hemorrhage grade II or more or periventricular leukomalacia grade II or more or retinopathy of prematurity requiring treatment) were not different.

Conclusion In this study, TCH infants had decreased odds of death before hospital discharge compared with FH but higher odds of BPD, which may be related to increased survival and differences in care practices.

Key Points

  • Few studies compared outcomes of premature infants between different high-income countries.

  • There are no studies comparing preterm infants between low middle-income and high-income countries such as India and the United States.

  • This study evaluated detailed comparison of care practices and infrastructure of NICUs in India and United states.

Keywords

preterm infants - neonatal intensive care unit - comparative analysis - outcomes research


Publikationsverlauf

Eingereicht: 11. August 2020

Angenommen: 11. Dezember 2020

Artikel online veröffentlicht:
24. Januar 2021

© 2021. Thieme. All rights reserved.

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  • References

  • 1 WHO. Causes of child mortality. Accessed July 24, 2020 at: http://www.who.int/gho/child_health/mortality/causes/en/
    PubMedGoogle Scholar
  • 2 Liu L, Oza S, Hogan D. et al. Global, regional, and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the Sustainable Development Goals. Lancet 2016; 388 (10063): 3027-3035
    CrossrefPubMedGoogle Scholar
  • 3 WHO. Born too soon. Accessed July 24, 2020 at: http://www.who.int/maternal_child_adolescent/documents/born_too_soon/en/
    PubMedGoogle Scholar
  • 4 Blencowe H, Cousens S, Oestergaard MZ. et al. National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications. Lancet 2012; 379 (9832): 2162-2172
    CrossrefPubMedGoogle Scholar
  • 5 Chawanpaiboon S, Vogel JP, Moller A-B. et al. Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis. Lancet Glob Health 2019; 7 (01) e37-e46
    CrossrefPubMedGoogle Scholar
  • 6 Martin JA, Hamilton BE, Osterman MJK. Births in the United States, 2018. NCHS Data Brief 2019; (346) 1-8
    PubMedGoogle Scholar
  • 7 Murki S, Kallem VR, Gururaj J, Bashir T, Oleti TP, Kiran S. Growth and neurodevelopmental outcomes at 12 to 18 months of corrected age in preterm infants born small for gestational age. Indian Pediatr 2020; 57 (04) 301-304
    CrossrefPubMedGoogle Scholar
  • 8 Mukhopadhyay K, Malhi P, Mahajan R, Narang A. Neurodevelopmental and behavioral outcome of very low birth weight babies at corrected age of 2 years. Indian J Pediatr 2010; 77 (09) 963-967
    CrossrefPubMedGoogle Scholar
  • 9 Mukhopadhyay K, Malhi P, Kumar J, Singhi P. Cognitive, language, and visuomotor abilities of very low birthweight infants at corrected age of two years. Indian Pediatr 2020; 57 (04) 296-300
    CrossrefPubMedGoogle Scholar
  • 10 Isayama T, Lee SK, Mori R. et al; Canadian Neonatal Network, Neonatal Research Network of Japan. Comparison of mortality and morbidity of very low birth weight infants between Canada and Japan. Pediatrics 2012; 130 (04) e957-e965
    CrossrefPubMedGoogle Scholar
  • 11 Su B-H, Hsieh W-S, Hsu C-H, Chang JH, Lien R, Lin CH. Premature Baby Foundation of Taiwan (PBFT). Neonatal outcomes of extremely preterm infants from taiwan: comparison with Canada, Japan, and the USA. Pediatr Neonatol 2015; 56 (01) 46-52
    CrossrefPubMedGoogle Scholar
  • 12 Hahn W-H, Chang J-Y, Chang YS, Shim KS, Bae C-W. Recent trends in neonatal mortality in very low birth weight Korean infants: in comparison with Japan and the USA. J Korean Med Sci 2011; 26 (04) 467-473
    CrossrefPubMedGoogle Scholar
  • 13 Shah PS, Lui K, Sjörs G. et al; International Network for Evaluating Outcomes (iNeo) of Neonates. Neonatal outcomes of very low birth weight and very preterm neonates: an international comparison. J Pediatr 2016; 177: 144-152.e6
    CrossrefPubMedGoogle Scholar
  • 14 Helenius K, Sjörs G, Shah PS. et al; International Network for Evaluating Outcomes (iNeo) of Neonates. Survival in very preterm infants: an international comparison of 10 national neonatal networks. Pediatrics 2017; 140 (06) e20171264
    CrossrefPubMedGoogle Scholar
  • 15 Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med 2001; 163 (07) 1723-1729
    Google Scholar
  • 16 Volpe JJ, Inder TE, Darras BT. et al. Volpe's Neurology of the Newborn. 6th ed.. Elsevier Health Sciences; 2018
    Google Scholar
  • 17 de Vries LS, Eken P, Dubowitz LM. The spectrum of leukomalacia using cranial ultrasound. Behav Brain Res 1992; 49 (01) 1-6
    CrossrefPubMedGoogle Scholar
  • 18 Walsh MC, Kliegman RM. Necrotizing enterocolitis: treatment based on staging criteria. Pediatr Clin North Am 1986; 33 (01) 179-201
    Google Scholar
  • 19 Early Treatment For Retinopathy Of Prematurity Cooperative Group. Revised indications for the treatment of retinopathy of prematurity: results of the early treatment for retinopathy of prematurity randomized trial. Arch Ophthalmol Chic Ill 1960 2003; 121 (12) 1684-1694
    PubMedGoogle Scholar
  • 20 Jain K, Sankar MJ, Nangia S. et al. Causes of death in preterm neonates (<33 weeks) born in tertiary care hospitals in India: analysis of three large prospective multicentric cohorts. J Perinatol 2019; 39 (Suppl. 01) 13-19
    CrossrefPubMedGoogle Scholar
  • 21 Jain K, Nangia S, Ballambattu VB. et al. Goat lung surfactant for treatment of respiratory distress syndrome among preterm neonates: a multi-site randomized non-inferiority trial. J Perinatol 2019; 39 (Suppl. 01) 3-12
    CrossrefPubMedGoogle Scholar
  • 22 Bhunwal S, Mukhopadhyay K, Bhattacharya S, Dey P, Dhaliwal LK. Bronchopulmonary dysplasia in preterm neonates in a level III neonatal unit in India. Indian Pediatr 2018; 55 (03) 211-215
    CrossrefPubMedGoogle Scholar
  • 23 Ananthan A, Balasubramanian H, Rao S, Patole S. Human milk-derived fortifiers compared with bovine milk-derived fortifiers in preterm infants: a systematic review and meta-analysis. Adv Nutr Bethesda Md.. Published online April 11, 2020 DOI: 10.1093/advances/nmaa039.
    CrossrefPubMedGoogle Scholar
  • 24 Benitz WE. Treatment of persistent patent ductus arteriosus in preterm infants: time to accept the null hypothesis?. J Perinatol 2010; 30 (04) 241-252
    CrossrefPubMedGoogle Scholar
  • 25 Schmidt B, Davis P, Moddemann D. et al; Trial of Indomethacin Prophylaxis in Preterms Investigators. Long-term effects of indomethacin prophylaxis in extremely-low-birth-weight infants. N Engl J Med 2001; 344 (26) 1966-1972
    CrossrefPubMedGoogle Scholar
  • 26 Roberts JC, Javed MJ, Hocker JR, Wang H, Tarantino MD. Risk factors associated with intraventricular hemorrhage in extremely premature neonates. Blood Coagul Fibrinolysis 2018; 29 (01) 25-29
    CrossrefPubMedGoogle Scholar
  • 27 Sharma D, Murki S, Pratap OT. To compare growth outcomes and cost-effectiveness of “Kangaroo ward care” with “intermediate intensive care” in stable extremely low birth weight infants: randomized control trial. J Matern Fetal Neonatal Med 2017; 30 (14) 1659-1665
    CrossrefPubMedGoogle Scholar