population based trends in mortality, morbidity and treatment for very preterm- and very low birth weight infants over 12 years基于人口趋势死亡率、发病率和治疗非常早产和低出生体重婴儿超过12年.pdfVIP

Rüegger et al. BMC Pediatrics 2012, 12:17 /1471-2431/12/17 RESEARCH ARTICLE Open Access Population based trends in mortality, morbidity and treatment for very preterm- and very low birth weight infants over 12 years 1,2* 1 1 1 Christoph Rüegger , Markus Hegglin , Mark Adams and Hans Ulrich Bucher , for the Swiss Neonatal Network Abstract Background: Over the last two decades, improvements in medical care have been associated with a significant increase and better outcome of very preterm (VP, 32 completed gestational weeks) and very low birth weight (VLBW, 1500 g) infants. Only a few publications analyse changes of their short-term outcome in a geographically defined area over more than 10 years. We therefore aimed to investigate the net change of VP- and VLBW infants leaving the hospital without major complications. Methods: Our population-based observational cohort study used the Minimal Neonatal Data Set, a database maintained by the Swiss Society of Neonatology including information of all VP- and VLBW infants. Perinatal characteristics, mortality and morbidity rates and the survival free of major complications were analysed and their temporal trends evaluated. Results: In 1996, 2000, 2004, and 2008, a total number of 3090 infants were enrolled in the Network Database. At the same time the rate of VP- and VLBW neonates increased significantly from 0.87% in 1996 to 1.10% in 2008 (p 0.001). The overall mortality remained stable by 13%, but the survival free of major complications increased from 66.9% to 71.7% (p 0.01). The percentage of infants getting a full course of antenatal corticosteroids increased from 67.7% in 1996 to 91.4% in 2008 (p 0.001). Surfactant was given more frequently (24.8% in 1996 compar