Mortality and morbidity of VLBW infants with trisomy 13 or trisomy 18

Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

OBJECTIVE: Little is known about how very low birth weight (VLBW) affects survival and morbidities among infants with trisomy 13 (T13) or trisomy 18 (T18). We examined the care plans for VLBW infants with T13 or T18 and compared their risks of mortality and neonatal morbidities with VLBW infants with trisomy 21 and VLBW infants without birth defects. METHODS: Infants with birth weight 401 to 1500 g born or cared for at a participating center of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network during the period 1994-2009 were studied. Poisson regression models were used to examine risk of death and neonatal morbidities among infants with T13 or T18. RESULTS: Of 52 262 VLBW infants, 38 (0.07%) had T13 and 128 (0.24%) had T18. Intensity of care in the delivery room varied depending on whether the trisomy was diagnosed before or after birth. The plan for subsequent care for the majority of the infants was to withdraw care or to provide comfort care. Eleven percent of infants with T13 and 9% of infants with T18 survived to hospital discharge. Survivors with T13 or T18 had significantly increased risk of patent ductus arteriosus and respiratory distress syndrome compared with infants without birth defects. No infant with T13 or T18 developed necrotizing enterocolitis. CONCLUSIONS: In this cohort of liveborn VLBW infants with T13 or T18, the timing of trisomy diagnosis affected the plan for care, survival was poor, and death usually occurred early.

Original languageEnglish (US)
Pages (from-to)226-235
Number of pages10
JournalPediatrics
Volume133
Issue number2
DOIs
StatePublished - Feb 1 2014
Externally publishedYes

Fingerprint

Very Low Birth Weight Infant
Morbidity
Mortality
Trisomy
National Institute of Child Health and Human Development (U.S.)
Delivery Rooms
Infant Care
Necrotizing Enterocolitis
Patent Ductus Arteriosus
Survival
Trisomy 18
Trisomy 13 syndrome
Infant Mortality
Down Syndrome
Birth Weight
Survivors
Parturition

Keywords

  • Preterm infants
  • Trisomy 13
  • Trisomy 18
  • Trisomy 21
  • Very low birth weight

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (2014). Mortality and morbidity of VLBW infants with trisomy 13 or trisomy 18. Pediatrics, 133(2), 226-235. https://doi.org/10.1542/peds.2013-1702

Mortality and morbidity of VLBW infants with trisomy 13 or trisomy 18. / Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network.

In: Pediatrics, Vol. 133, No. 2, 01.02.2014, p. 226-235.

Research output: Contribution to journalArticle

Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network 2014, 'Mortality and morbidity of VLBW infants with trisomy 13 or trisomy 18', Pediatrics, vol. 133, no. 2, pp. 226-235. https://doi.org/10.1542/peds.2013-1702
Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Mortality and morbidity of VLBW infants with trisomy 13 or trisomy 18. Pediatrics. 2014 Feb 1;133(2):226-235. https://doi.org/10.1542/peds.2013-1702
Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. / Mortality and morbidity of VLBW infants with trisomy 13 or trisomy 18. In: Pediatrics. 2014 ; Vol. 133, No. 2. pp. 226-235.
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T1 - Mortality and morbidity of VLBW infants with trisomy 13 or trisomy 18

AU - Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network

AU - Boghossian, Nansi S.

AU - Hansen, Nellie I.

AU - Bell, Edward F.

AU - Stoll, Barbara J.

AU - Murray, Jeffrey C.

AU - Carey, John C.

AU - Adams-Chapman, Ira

AU - Shankaran, Seetha

AU - Walsh, Michele C.

AU - Laptook, Abbot R.

AU - Faix, Roger G.

AU - Newman, Nancy S.

AU - Hale, Ellen C.

AU - Das, Abhik

AU - Wilson, Leslie D.

AU - Hensman, Angelita M.

AU - Grisby, Cathy

AU - Collins, Monica V.

AU - Vasil, Diana M.

AU - Finkle, Joanne

AU - Maffett, Deanna

AU - Ball, M. Bethany

AU - Lacy, Conra B.

AU - Bara, Rebecca

AU - Higgins, Rosemary D.

AU - Jobe, A. H.

AU - Caplan, M. S.

AU - Oh, W.

AU - Fanaroff, A. A.

AU - Siner, B. S.

AU - Schibler, K.

AU - Donovan, E. F.

AU - Bridges, K.

AU - Alexander, B.

AU - Mincey, H. L.

AU - Hessling, J.

AU - Mersmann, M. W.

AU - Jackson, L. D.

AU - Kirker, K.

AU - Fischer, E. E.

AU - Goldberg, R. N.

AU - Cotten, C.

AU - Fisher, K. A.

AU - Carlton, D. P.

AU - Jain, L.

AU - Wright, L. L.

AU - Archer, S. W.

AU - McClure, E. M.

AU - Poindexter, B. B.

AU - Wallace, David K.

PY - 2014/2/1

Y1 - 2014/2/1

N2 - OBJECTIVE: Little is known about how very low birth weight (VLBW) affects survival and morbidities among infants with trisomy 13 (T13) or trisomy 18 (T18). We examined the care plans for VLBW infants with T13 or T18 and compared their risks of mortality and neonatal morbidities with VLBW infants with trisomy 21 and VLBW infants without birth defects. METHODS: Infants with birth weight 401 to 1500 g born or cared for at a participating center of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network during the period 1994-2009 were studied. Poisson regression models were used to examine risk of death and neonatal morbidities among infants with T13 or T18. RESULTS: Of 52 262 VLBW infants, 38 (0.07%) had T13 and 128 (0.24%) had T18. Intensity of care in the delivery room varied depending on whether the trisomy was diagnosed before or after birth. The plan for subsequent care for the majority of the infants was to withdraw care or to provide comfort care. Eleven percent of infants with T13 and 9% of infants with T18 survived to hospital discharge. Survivors with T13 or T18 had significantly increased risk of patent ductus arteriosus and respiratory distress syndrome compared with infants without birth defects. No infant with T13 or T18 developed necrotizing enterocolitis. CONCLUSIONS: In this cohort of liveborn VLBW infants with T13 or T18, the timing of trisomy diagnosis affected the plan for care, survival was poor, and death usually occurred early.

AB - OBJECTIVE: Little is known about how very low birth weight (VLBW) affects survival and morbidities among infants with trisomy 13 (T13) or trisomy 18 (T18). We examined the care plans for VLBW infants with T13 or T18 and compared their risks of mortality and neonatal morbidities with VLBW infants with trisomy 21 and VLBW infants without birth defects. METHODS: Infants with birth weight 401 to 1500 g born or cared for at a participating center of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network during the period 1994-2009 were studied. Poisson regression models were used to examine risk of death and neonatal morbidities among infants with T13 or T18. RESULTS: Of 52 262 VLBW infants, 38 (0.07%) had T13 and 128 (0.24%) had T18. Intensity of care in the delivery room varied depending on whether the trisomy was diagnosed before or after birth. The plan for subsequent care for the majority of the infants was to withdraw care or to provide comfort care. Eleven percent of infants with T13 and 9% of infants with T18 survived to hospital discharge. Survivors with T13 or T18 had significantly increased risk of patent ductus arteriosus and respiratory distress syndrome compared with infants without birth defects. No infant with T13 or T18 developed necrotizing enterocolitis. CONCLUSIONS: In this cohort of liveborn VLBW infants with T13 or T18, the timing of trisomy diagnosis affected the plan for care, survival was poor, and death usually occurred early.

KW - Preterm infants

KW - Trisomy 13

KW - Trisomy 18

KW - Trisomy 21

KW - Very low birth weight

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