Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network

Barbara J. Stoll, Nellie I. Hansen, Edward F. Bell, Seetha Shankaran, Abbot R. Laptook, Michele C. Walsh, Ellen C. Hale, Nancy S. Newman, Kurt Schibler, Waldemar A. Carlo, Kathleen A. Kennedy, Brenda B. Poindexter, Neil N. Finer, Richard A. Ehrenkranz, Shahnaz Duara, Pablo J. Sánchez, T. Michael O'Shea, Ronald N. Goldberg, Krisa P. Van Meurs, Roger G. FaixDale L. Phelps, Ivan D. Frantz, Kristi L. Watterberg, Shampa Saha, Abhik Das, Rosemary D. Higgins

Research output: Contribution to journalArticle

1281 Citations (Scopus)

Abstract

OBJECTIVE: This report presents data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network on care of and morbidity and mortality rates for very low birth weight infants, according to gestational age (GA). METHODS: Perinatal/neonatal data were collected for 9575 infants of extremely low GA (22-28 weeks) and very low birth weight (401-1500 g) who were born at network centers between January 1, 2003, and December 31, 2007. RESULTS: Rates of survival to discharge increased with increasing GA (6% at 22 weeks and 92% at 28 weeks); 1060 infants died at ≤12 hours, with most early deaths occurring at 22 and 23 weeks (85% and 43%, respectively). Rates of prenatal steroid use (13% and 53%, respectively), cesarean section (7% and 24%, respectively), and delivery room intubation (19% and 68%, respectively) increased markedly between 22 and 23 weeks. Infants at the lowest GAs were at greatest risk for morbidities. Overall, 93% had respiratory distress syndrome, 46% patent ductus arteriosus, 16% severe intraventricular hemorrhage, 11% necrotizing enterocolitis, and 36% late-onset sepsis. The new severity-based definition of bronchopulmonary dysplasia classified more infants as having bronchopulmonary dysplasia than did the traditional definition of supplemental oxygen use at 36 weeks (68%, compared with 42%). More than one-half of infants with extremely low GAs had undetermined retinopathy status at the time of discharge. Center differences in management and outcomes were identified. CONCLUSION: Although the majority of infants with GAs of ≥24 weeks survive, high rates of morbidity among survivors continue to be observed.

Original languageEnglish
Pages (from-to)443-456
Number of pages14
JournalPediatrics
Volume126
Issue number3
DOIs
StatePublished - 2010

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National Institute of Child Health and Human Development (U.S.)
Extremely Premature Infants
Research
Gestational Age
Bronchopulmonary Dysplasia
Very Low Birth Weight Infant
Morbidity
Delivery Rooms
Necrotizing Enterocolitis
Patent Ductus Arteriosus
Intubation
Cesarean Section
Survivors
Sepsis
Survival Rate
Steroids
Hemorrhage
Oxygen
Mortality

Keywords

  • Death
  • Extremely low gestation
  • Morbidity
  • Very low birth weight

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

Cite this

Stoll, B. J., Hansen, N. I., Bell, E. F., Shankaran, S., Laptook, A. R., Walsh, M. C., ... Higgins, R. D. (2010). Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network. Pediatrics, 126(3), 443-456. https://doi.org/10.1542/peds.2009-2959

Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network. / Stoll, Barbara J.; Hansen, Nellie I.; Bell, Edward F.; Shankaran, Seetha; Laptook, Abbot R.; Walsh, Michele C.; Hale, Ellen C.; Newman, Nancy S.; Schibler, Kurt; Carlo, Waldemar A.; Kennedy, Kathleen A.; Poindexter, Brenda B.; Finer, Neil N.; Ehrenkranz, Richard A.; Duara, Shahnaz; Sánchez, Pablo J.; O'Shea, T. Michael; Goldberg, Ronald N.; Van Meurs, Krisa P.; Faix, Roger G.; Phelps, Dale L.; Frantz, Ivan D.; Watterberg, Kristi L.; Saha, Shampa; Das, Abhik; Higgins, Rosemary D.

In: Pediatrics, Vol. 126, No. 3, 2010, p. 443-456.

Research output: Contribution to journalArticle

Stoll, BJ, Hansen, NI, Bell, EF, Shankaran, S, Laptook, AR, Walsh, MC, Hale, EC, Newman, NS, Schibler, K, Carlo, WA, Kennedy, KA, Poindexter, BB, Finer, NN, Ehrenkranz, RA, Duara, S, Sánchez, PJ, O'Shea, TM, Goldberg, RN, Van Meurs, KP, Faix, RG, Phelps, DL, Frantz, ID, Watterberg, KL, Saha, S, Das, A & Higgins, RD 2010, 'Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network', Pediatrics, vol. 126, no. 3, pp. 443-456. https://doi.org/10.1542/peds.2009-2959
Stoll BJ, Hansen NI, Bell EF, Shankaran S, Laptook AR, Walsh MC et al. Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network. Pediatrics. 2010;126(3):443-456. https://doi.org/10.1542/peds.2009-2959
Stoll, Barbara J. ; Hansen, Nellie I. ; Bell, Edward F. ; Shankaran, Seetha ; Laptook, Abbot R. ; Walsh, Michele C. ; Hale, Ellen C. ; Newman, Nancy S. ; Schibler, Kurt ; Carlo, Waldemar A. ; Kennedy, Kathleen A. ; Poindexter, Brenda B. ; Finer, Neil N. ; Ehrenkranz, Richard A. ; Duara, Shahnaz ; Sánchez, Pablo J. ; O'Shea, T. Michael ; Goldberg, Ronald N. ; Van Meurs, Krisa P. ; Faix, Roger G. ; Phelps, Dale L. ; Frantz, Ivan D. ; Watterberg, Kristi L. ; Saha, Shampa ; Das, Abhik ; Higgins, Rosemary D. / Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network. In: Pediatrics. 2010 ; Vol. 126, No. 3. pp. 443-456.
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abstract = "OBJECTIVE: This report presents data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network on care of and morbidity and mortality rates for very low birth weight infants, according to gestational age (GA). METHODS: Perinatal/neonatal data were collected for 9575 infants of extremely low GA (22-28 weeks) and very low birth weight (401-1500 g) who were born at network centers between January 1, 2003, and December 31, 2007. RESULTS: Rates of survival to discharge increased with increasing GA (6{\%} at 22 weeks and 92{\%} at 28 weeks); 1060 infants died at ≤12 hours, with most early deaths occurring at 22 and 23 weeks (85{\%} and 43{\%}, respectively). Rates of prenatal steroid use (13{\%} and 53{\%}, respectively), cesarean section (7{\%} and 24{\%}, respectively), and delivery room intubation (19{\%} and 68{\%}, respectively) increased markedly between 22 and 23 weeks. Infants at the lowest GAs were at greatest risk for morbidities. Overall, 93{\%} had respiratory distress syndrome, 46{\%} patent ductus arteriosus, 16{\%} severe intraventricular hemorrhage, 11{\%} necrotizing enterocolitis, and 36{\%} late-onset sepsis. The new severity-based definition of bronchopulmonary dysplasia classified more infants as having bronchopulmonary dysplasia than did the traditional definition of supplemental oxygen use at 36 weeks (68{\%}, compared with 42{\%}). More than one-half of infants with extremely low GAs had undetermined retinopathy status at the time of discharge. Center differences in management and outcomes were identified. CONCLUSION: Although the majority of infants with GAs of ≥24 weeks survive, high rates of morbidity among survivors continue to be observed.",
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T1 - Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network

AU - Stoll, Barbara J.

AU - Hansen, Nellie I.

AU - Bell, Edward F.

AU - Shankaran, Seetha

AU - Laptook, Abbot R.

AU - Walsh, Michele C.

AU - Hale, Ellen C.

AU - Newman, Nancy S.

AU - Schibler, Kurt

AU - Carlo, Waldemar A.

AU - Kennedy, Kathleen A.

AU - Poindexter, Brenda B.

AU - Finer, Neil N.

AU - Ehrenkranz, Richard A.

AU - Duara, Shahnaz

AU - Sánchez, Pablo J.

AU - O'Shea, T. Michael

AU - Goldberg, Ronald N.

AU - Van Meurs, Krisa P.

AU - Faix, Roger G.

AU - Phelps, Dale L.

AU - Frantz, Ivan D.

AU - Watterberg, Kristi L.

AU - Saha, Shampa

AU - Das, Abhik

AU - Higgins, Rosemary D.

PY - 2010

Y1 - 2010

N2 - OBJECTIVE: This report presents data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network on care of and morbidity and mortality rates for very low birth weight infants, according to gestational age (GA). METHODS: Perinatal/neonatal data were collected for 9575 infants of extremely low GA (22-28 weeks) and very low birth weight (401-1500 g) who were born at network centers between January 1, 2003, and December 31, 2007. RESULTS: Rates of survival to discharge increased with increasing GA (6% at 22 weeks and 92% at 28 weeks); 1060 infants died at ≤12 hours, with most early deaths occurring at 22 and 23 weeks (85% and 43%, respectively). Rates of prenatal steroid use (13% and 53%, respectively), cesarean section (7% and 24%, respectively), and delivery room intubation (19% and 68%, respectively) increased markedly between 22 and 23 weeks. Infants at the lowest GAs were at greatest risk for morbidities. Overall, 93% had respiratory distress syndrome, 46% patent ductus arteriosus, 16% severe intraventricular hemorrhage, 11% necrotizing enterocolitis, and 36% late-onset sepsis. The new severity-based definition of bronchopulmonary dysplasia classified more infants as having bronchopulmonary dysplasia than did the traditional definition of supplemental oxygen use at 36 weeks (68%, compared with 42%). More than one-half of infants with extremely low GAs had undetermined retinopathy status at the time of discharge. Center differences in management and outcomes were identified. CONCLUSION: Although the majority of infants with GAs of ≥24 weeks survive, high rates of morbidity among survivors continue to be observed.

AB - OBJECTIVE: This report presents data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network on care of and morbidity and mortality rates for very low birth weight infants, according to gestational age (GA). METHODS: Perinatal/neonatal data were collected for 9575 infants of extremely low GA (22-28 weeks) and very low birth weight (401-1500 g) who were born at network centers between January 1, 2003, and December 31, 2007. RESULTS: Rates of survival to discharge increased with increasing GA (6% at 22 weeks and 92% at 28 weeks); 1060 infants died at ≤12 hours, with most early deaths occurring at 22 and 23 weeks (85% and 43%, respectively). Rates of prenatal steroid use (13% and 53%, respectively), cesarean section (7% and 24%, respectively), and delivery room intubation (19% and 68%, respectively) increased markedly between 22 and 23 weeks. Infants at the lowest GAs were at greatest risk for morbidities. Overall, 93% had respiratory distress syndrome, 46% patent ductus arteriosus, 16% severe intraventricular hemorrhage, 11% necrotizing enterocolitis, and 36% late-onset sepsis. The new severity-based definition of bronchopulmonary dysplasia classified more infants as having bronchopulmonary dysplasia than did the traditional definition of supplemental oxygen use at 36 weeks (68%, compared with 42%). More than one-half of infants with extremely low GAs had undetermined retinopathy status at the time of discharge. Center differences in management and outcomes were identified. CONCLUSION: Although the majority of infants with GAs of ≥24 weeks survive, high rates of morbidity among survivors continue to be observed.

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