Impact of Intensive Care Practices on Short-Term and Long-term Outcomes for Extremely Preterm Infants: Comparison Between the British Isles and France

被引:35
作者
Bodeau-Livinec, Florence [1 ,2 ,3 ]
Marlow, Neil [4 ]
Ancel, Pierre-Yves [1 ,2 ]
Kurinczuk, Jennifer J. [3 ]
Costeloe, Kate [5 ]
Kaminski, Monique [1 ,2 ]
机构
[1] Hop Tenon, INSERM, UMR S149, IFR 69,Unit Perinatal & Womens Hlth, F-75970 Paris, France
[2] Univ Paris 06, Paris, France
[3] Univ Oxford, Natl Perinatal Epidemiol Unit, Oxford, England
[4] Univ Nottingham, Dept Paediat, Nottingham NG7 2RD, England
[5] Univ London, Barts & London Queen Marys Sch Med & Dent, London, England
基金
英国医学研究理事会;
关键词
population-based study; very preterm infants; perinatal mortality; cerebral palsy; cognitive impairment;
D O I
10.1542/peds.2007-2976
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
OBJECTIVES. The objective of this study was to compare practices of care and outcomes of infants who were born between 23 and 25 weeks' gestation in 1995 in the British Isles and in 1997-1998 in France. METHODS. We examined 2 population-based cohorts in the British Isles (1892 births included) and in France (456 births): the EPICure and EPIPAGE studies. The rate of follow-up was 90% at 30 months and 86% at 2 years. At 5 to 6 years, the cognitive function of 64% of the children without severe disability was assessed in the EPICure study and 57% in the EPIPAGE study. RESULTS. The mortality rate of live-born infants was lower in the EPICure study (25%) than in the EPIPAGE study (34%) before admission to a NICU but higher in the NICU (45% vs 29%, respectively), such that there was no difference in the proportions of survivors at discharge after adjustment for gestational age. The risk for severe brain lesions was 24% among infants who were admitted to a NICU in both studies, 41% in the EPICure study versus 67% in the epidemiologic study on great prematurity (EPIPAGE) among infants who died after discontinued treatment in NICU, and 17% vs 11% among survivors at discharge. The risk for cerebral palsy at 24 to 30 months was 20% in the EPICure study versus 16% in the EPIPAGE study, whereas the risk for overall cognitive score of < 70 at 5 to 6 years was 10% vs 14%, respectively. CONCLUSIONS. Despite apparent differences in the modalities of limitation of intensive care, the outcomes of infants who were born at 23 to 25 weeks' gestation in the EPICure and EPIPAGE studies were not significantly different. Pediatrics 2008; 122: e1014-e1021
引用
收藏
页码:E1014 / E1021
页数:8
相关论文
共 31 条
[1]  
ANATAYANONTH S, 2004, COCHRANE DB SYST REV
[2]   Neurobehavioral outcomes of school-age children born extremely low birth weight or very preterm in the 1990s [J].
Anderson, P ;
Doyle, LW .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2003, 289 (24) :3264-3272
[3]  
[Anonymous], 1998, MANUAL NEPSY DEV NEU
[4]   Cognitive and behavioral outcomes of school-aged children who were born preterm - A meta-analysis [J].
Bhutta, AT ;
Cleves, MA ;
Casey, PH ;
Cradock, MM ;
Anand, KJS .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2002, 288 (06) :728-737
[5]   THE USE OF ULTRASOUND EXAMINATIONS, INTRAPARTUM FETAL HEART-RATE MONITORING AND BETA-MIMETIC DRUGS IN FRANCE [J].
BLONDEL, B ;
RINGA, V ;
BREART, G .
BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY, 1989, 96 (01) :44-51
[6]   Surveillance of cerebral palsy in Europe:: a collaboration of cerebral palsy surveys and registers [J].
Cans, C ;
Guillem, P ;
Baille, F ;
Arnaud, C ;
Chalmers, J ;
Cussen, G ;
McManus, V ;
Parkes, J ;
Dolk, H ;
Hagberg, G ;
Hagberg, B ;
Hensey, O ;
Dowding, V ;
Jarvis, S ;
Colver, A ;
Johnson, A ;
Surmann, G ;
Krägeloh-Mann, I ;
Michaelis, R ;
Pharoah, P ;
Platt, MJ ;
Topp, M ;
Udall, P ;
Torrioli, MG ;
Miceli, M ;
Wichers, M ;
van Nieuwenhuizen, O .
DEVELOPMENTAL MEDICINE AND CHILD NEUROLOGY, 2000, 42 (12) :816-824
[7]  
COCKBURN F, 1993, LANCET, V342, P193
[8]   The EPICure study: Outcomes to discharge from hospital for infants born at the threshold of viability [J].
Costeloe, K ;
Hennessy, E ;
Gibson, AT ;
Marlow, N ;
Wilkinson, AR .
PEDIATRICS, 2000, 106 (04) :659-671
[9]   End-of-life decisions in neonatal intensive care: physicians' self-reported practices in seven European countries [J].
Cuttini, M ;
Nadai, M ;
Kaminski, M ;
Hansen, G ;
de Leeuw, R ;
Lenoir, S ;
Persson, J ;
Rebagliato, M ;
Reid, M ;
de Vonderweid, U ;
Lenard, HG ;
Orzalesi, M ;
Saracci, R .
LANCET, 2000, 355 (9221) :2112-2118
[10]   Cerebral palsy, low birthweight and socio-economic deprivation: inequalities in a major cause of childhood disability [J].
Dolk, H ;
Pattenden, S ;
Johnson, A .
PAEDIATRIC AND PERINATAL EPIDEMIOLOGY, 2001, 15 (04) :359-363