Trends in outcome of extreme preterms – a retrospective cohort study on neonatal mortality and morbidity

Hengeveld, V.S. (2016) Trends in outcome of extreme preterms – a retrospective cohort study on neonatal mortality and morbidity. thesis, Medicine.

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Abstract

Preterm delivery remains one of the most intractable problems contributing to perinatal mortality and morbidity in developed countries. In the Netherlands, 1 in 1000 pregnancies results in an extremely preterm delivery (gestational age (GA) <27 weeks). Although technical improvements in perinatal care have led to an increase in survival, mortality in these neonates still remains high. Furthermore, a large proportion of survivors suffers one or more major complications (such as necrotizing enterocolitis, bronchopulmonary dysplasia, retinopathy of prematurity, patent ductus arteriosus, intraventricular hemorrhage or periventricular leukomalacia.) during and/or after their stay at the Neonatal Intensive Care Unit. To equalize perinatal care in the Netherlands, the national guideline ‘Perinatal policy in cases of extremely preterm delivery’ was introduced by the Dutch Society for Pediatrics and Dutch Society for Obstetrics and Gynecology in 2012. One of the most important recommendations in this guideline was a shift of the threshold for active treatment from 25 to 24 weeks’ GA. This retrospective cohort study evaluates trends in short and long term mortality and morbidity in the UMCG before and after introduction of the guideline. We collected data on maternal and newborn characteristics using an existing database that was completed with additional data from (electronic) patient files. Comparison of cohorts before and after introduction of the guideline showed no significant difference in mortality between cohorts. With respect to morbidities, incidence of necrotizing enterocolitis had increased since introduction of the guideline and on the longer term, neurologic outcome seemed improved.

Item Type:	Thesis (Thesis)
Supervisor name:	Faculty supervisor: and Vetten, L. De and Second supervisor: and Bos, A. F. and Location: Department of Neonatology, University Medical Cent
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:50
Last Modified:	25 Jun 2020 10:50
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1098

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