22 Jan Deaths in Premature Infants Decline Over Twelve Years

Posted at 01:43h in Author Interviews, Emory, NEJM by Marie Benz MD FAAD

MedicalResearch.com Interview with:
Ravi Mangal Patel, MD MSc
Assistant Professor of Pediatrics
Division of Neonatology
Emory University School of Medicine

Medical Research: What is the background for this study?

Response: We sought to understand the major causes of death and when these deaths occur among extremely premature infants (those born at 22 0/7 to 28 6/7 weeks of gestation). We evaluated a cohort of 22,248 extremely premature infants born at hospitals that were part of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network, a research network comprised of academic medical centers across the United States. We evaluated changes over time in survival by comparing in-hospital deaths among live births during three periods from 2000 to 2011.

Medical Research: What are the main findings?

Response: The main finding of our study is that survival improved for extremely premature infants from 2000 through 2011, largely due to a decrease in deaths from pulmonary causes (respiratory distress syndrome and bronchopulmonary dysplasia). The improvement in survival from 2000 to 2011 was primarily from decreases in mortality rates from 2004-2007 to 2008-2011, where the overall mortality rate decreased by 9.6%. However, we also found that one cause of death, necrotizing enterocolitis (an intestinal complication related to premature birth), increased from 2000 to 2011.

Medical Research: What at should clinicians and patients take away from your report?

Response: Survival continues to improve for extremely premature infants, in large part from fewer babies dying in recent years of respiratory complications of preterm birth. We also demonstrate that the causes and timing of death vary substantially among extremely premature infants depending on their gestational age at birth. We feel this information can be useful for clinicians, as they care for extremely premature infants and counsel their families.

Medical Research: What recommendations do you have for future research as a result of this study?

Response: Although our study demonstrates that overall survival has improved in recent years among extremely premature infants, mortality rates still remain unacceptably high among this population. Our findings underscore the continued need to identify and implement strategies to reduce potentially lethal complications of prematurity. Ultimately, strategies to reduce extremely preterm births are needed to make a significant impact on infant mortality.

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