Neonatal outcomes of moderately preterm infants compared to extremely preterm infants

Michele C. Walsh; Edward F. Bell; Sarah Kandefer; Shampa Saha; Waldemar A. Carlo; Carl T. D'angio; Abbot R. Laptook; Pablo J. Sanchez; Barbara J. Stoll; Seetha Shankaran; Krisa P. Van Meurs; Noah Cook; Rosemary D. Higgins; Abhik Das; Nancy S. Newman; Kurt Schibler; Barbara Schmidt; C. Michael Cotten; Brenda B. Poindexter; Kristi L. Watterberg; William E. Truog

doi:10.1038/pr.2017.46

Neonatal outcomes of moderately preterm infants compared to extremely preterm infants

Michele C. Walsh, Edward F. Bell, Sarah Kandefer, Shampa Saha, Waldemar A. Carlo, Carl T. D'angio, Abbot R. Laptook, Pablo J. Sanchez, Barbara J. Stoll, Seetha Shankaran, Krisa P. Van Meurs, Noah Cook, Rosemary D. Higgins, Abhik Das, Nancy S. Newman, Kurt Schibler, Barbara Schmidt, C. Michael Cotten, Brenda B. Poindexter, Kristi L. WatterbergWilliam E. Truog

Pediatrics

Research output: Contribution to journal › Article › peer-review

68 Scopus citations

Abstract

BackgroundExtremely preterm infants (EPT, <29 weeks' gestation) represent only 0.9% of births in the United States; yet these infants are the focus of most published research. Moderately preterm neonates (MPT, 29-33 6/7 weeks) are an understudied group of high-risk infants.MethodsTo determine the neonatal outcomes of MPT infants across the gestational age spectrum, and to compare these with EPT infants. A prospective observational cohort was formed in 18 level 3-4 neonatal intensive care units (NICUs) in the Eunice Kennedy Shriver NICHD Neonatal Research Network. Participants included all MPT infants admitted to NICUs and all EPT infants born at sites between January 2012 and November 2013. Antenatal characteristics and neonatal morbidities were abstracted from records using pre-specified definitions by trained neonatal research nurses.ResultsMPT infants experienced morbidities similar to, although at lower rates than, those of EPT infants. The main cause of mortality was congenital malformation, accounting for 43% of deaths. Central Nervous System injury occurred, including intraventricular hemorrhage. Most MPT infants required respiratory support, but sequelae such as bronchopulmonary dysplasia were rare. The primary contributors to hospitalization beyond 36 weeks' gestation were inability to achieve adequate oral intake and persistent apnea.ConclusionsMPT infants experience morbidity and prolonged hospitalization. Such morbidity deserves focused research to improve therapeutic and prevention strategies.

Original language	English (US)
Pages (from-to)	297-304
Number of pages	8
Journal	Pediatric Research
Volume	82
Issue number	2
DOIs	https://doi.org/10.1038/pr.2017.46
State	Published - Aug 1 2017

ASJC Scopus subject areas

Pediatrics, Perinatology, and Child Health

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10.1038/pr.2017.46

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Walsh, M. C., Bell, E. F., Kandefer, S., Saha, S., Carlo, W. A., D'angio, C. T., Laptook, A. R., Sanchez, P. J., Stoll, B. J., Shankaran, S., Van Meurs, K. P., Cook, N., Higgins, R. D., Das, A., Newman, N. S., Schibler, K., Schmidt, B., Cotten, C. M., Poindexter, B. B., ... Truog, W. E. (2017). Neonatal outcomes of moderately preterm infants compared to extremely preterm infants. Pediatric Research, 82(2), 297-304. https://doi.org/10.1038/pr.2017.46

Walsh, MC, Bell, EF, Kandefer, S, Saha, S, Carlo, WA, D'angio, CT, Laptook, AR, Sanchez, PJ, Stoll, BJ, Shankaran, S, Van Meurs, KP, Cook, N, Higgins, RD, Das, A, Newman, NS, Schibler, K, Schmidt, B, Cotten, CM, Poindexter, BB, Watterberg, KL & Truog, WE 2017, 'Neonatal outcomes of moderately preterm infants compared to extremely preterm infants', Pediatric Research, vol. 82, no. 2, pp. 297-304. https://doi.org/10.1038/pr.2017.46

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title = "Neonatal outcomes of moderately preterm infants compared to extremely preterm infants",

abstract = "BackgroundExtremely preterm infants (EPT, <29 weeks' gestation) represent only 0.9% of births in the United States; yet these infants are the focus of most published research. Moderately preterm neonates (MPT, 29-33 6/7 weeks) are an understudied group of high-risk infants.MethodsTo determine the neonatal outcomes of MPT infants across the gestational age spectrum, and to compare these with EPT infants. A prospective observational cohort was formed in 18 level 3-4 neonatal intensive care units (NICUs) in the Eunice Kennedy Shriver NICHD Neonatal Research Network. Participants included all MPT infants admitted to NICUs and all EPT infants born at sites between January 2012 and November 2013. Antenatal characteristics and neonatal morbidities were abstracted from records using pre-specified definitions by trained neonatal research nurses.ResultsMPT infants experienced morbidities similar to, although at lower rates than, those of EPT infants. The main cause of mortality was congenital malformation, accounting for 43% of deaths. Central Nervous System injury occurred, including intraventricular hemorrhage. Most MPT infants required respiratory support, but sequelae such as bronchopulmonary dysplasia were rare. The primary contributors to hospitalization beyond 36 weeks' gestation were inability to achieve adequate oral intake and persistent apnea.ConclusionsMPT infants experience morbidity and prolonged hospitalization. Such morbidity deserves focused research to improve therapeutic and prevention strategies.",

author = "Walsh, {Michele C.} and Bell, {Edward F.} and Sarah Kandefer and Shampa Saha and Carlo, {Waldemar A.} and D'angio, {Carl T.} and Laptook, {Abbot R.} and Sanchez, {Pablo J.} and Stoll, {Barbara J.} and Seetha Shankaran and {Van Meurs}, {Krisa P.} and Noah Cook and Higgins, {Rosemary D.} and Abhik Das and Newman, {Nancy S.} and Kurt Schibler and Barbara Schmidt and Cotten, {C. Michael} and Poindexter, {Brenda B.} and Watterberg, {Kristi L.} and Truog, {William E.}",

note = "Publisher Copyright: {\textcopyright} 2017 International Pediatric Research Foundation, Inc.",

year = "2017",

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doi = "10.1038/pr.2017.46",

language = "English (US)",

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T1 - Neonatal outcomes of moderately preterm infants compared to extremely preterm infants

AU - Walsh, Michele C.

AU - Bell, Edward F.

AU - Kandefer, Sarah

AU - Saha, Shampa

AU - Carlo, Waldemar A.

AU - D'angio, Carl T.

AU - Laptook, Abbot R.

AU - Sanchez, Pablo J.

AU - Stoll, Barbara J.

AU - Shankaran, Seetha

AU - Van Meurs, Krisa P.

AU - Cook, Noah

AU - Higgins, Rosemary D.

AU - Das, Abhik

AU - Newman, Nancy S.

AU - Schibler, Kurt

AU - Schmidt, Barbara

AU - Cotten, C. Michael

AU - Poindexter, Brenda B.

AU - Watterberg, Kristi L.

AU - Truog, William E.

PY - 2017/8/1

Y1 - 2017/8/1

N2 - BackgroundExtremely preterm infants (EPT, <29 weeks' gestation) represent only 0.9% of births in the United States; yet these infants are the focus of most published research. Moderately preterm neonates (MPT, 29-33 6/7 weeks) are an understudied group of high-risk infants.MethodsTo determine the neonatal outcomes of MPT infants across the gestational age spectrum, and to compare these with EPT infants. A prospective observational cohort was formed in 18 level 3-4 neonatal intensive care units (NICUs) in the Eunice Kennedy Shriver NICHD Neonatal Research Network. Participants included all MPT infants admitted to NICUs and all EPT infants born at sites between January 2012 and November 2013. Antenatal characteristics and neonatal morbidities were abstracted from records using pre-specified definitions by trained neonatal research nurses.ResultsMPT infants experienced morbidities similar to, although at lower rates than, those of EPT infants. The main cause of mortality was congenital malformation, accounting for 43% of deaths. Central Nervous System injury occurred, including intraventricular hemorrhage. Most MPT infants required respiratory support, but sequelae such as bronchopulmonary dysplasia were rare. The primary contributors to hospitalization beyond 36 weeks' gestation were inability to achieve adequate oral intake and persistent apnea.ConclusionsMPT infants experience morbidity and prolonged hospitalization. Such morbidity deserves focused research to improve therapeutic and prevention strategies.

AB - BackgroundExtremely preterm infants (EPT, <29 weeks' gestation) represent only 0.9% of births in the United States; yet these infants are the focus of most published research. Moderately preterm neonates (MPT, 29-33 6/7 weeks) are an understudied group of high-risk infants.MethodsTo determine the neonatal outcomes of MPT infants across the gestational age spectrum, and to compare these with EPT infants. A prospective observational cohort was formed in 18 level 3-4 neonatal intensive care units (NICUs) in the Eunice Kennedy Shriver NICHD Neonatal Research Network. Participants included all MPT infants admitted to NICUs and all EPT infants born at sites between January 2012 and November 2013. Antenatal characteristics and neonatal morbidities were abstracted from records using pre-specified definitions by trained neonatal research nurses.ResultsMPT infants experienced morbidities similar to, although at lower rates than, those of EPT infants. The main cause of mortality was congenital malformation, accounting for 43% of deaths. Central Nervous System injury occurred, including intraventricular hemorrhage. Most MPT infants required respiratory support, but sequelae such as bronchopulmonary dysplasia were rare. The primary contributors to hospitalization beyond 36 weeks' gestation were inability to achieve adequate oral intake and persistent apnea.ConclusionsMPT infants experience morbidity and prolonged hospitalization. Such morbidity deserves focused research to improve therapeutic and prevention strategies.

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Neonatal outcomes of moderately preterm infants compared to extremely preterm infants

Abstract

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