Antenatal prediction of neonatal mortality in very premature infants (original) (raw)

2014, European Journal of Obstetrics & Gynecology and Reproductive Biology

Preterm birth is the leading cause of neonatal morbidity and mortality in high income countries [1], and is estimated to be responsible for a million neonatal deaths worldwide each year [2]. The consequences of preterm birth arise from the fact that the immature organ systems of the neonate are not yet prepared to support extrauterine life. This is expressed in respiratory insufficiency, intracranial hemorrhage and infections. The impact of very preterm birth, defined as birth before 32 completed weeks of gestation, on neonatal morbidity and mortality risk is dependent on the actual length of gestation, as the risk decreases when pregnancy progresses [3-5]. The risk of neonatal complications in very preterm birth influences antenatal clinical decision-making concerning the administration of tocolytics/corticosteroids and/or referral to a 3rd level perinatal centre [6,7]. Prediction models can be a helpful tool for clinicians working in perinatal care [8-10]. To assess the risk of neonatal mortality in infants born very preterm there are around 40 prediction models available to clinicians [11]. Medlock et al. systematically reviewed all these prediction models and found that besides gestational age and birth weight, several other variables were recurrently found to be independent predictors for neonatal mortality after very preterm birth. These predictors were: being small for gestational age (SGA), male gender, white ethnicity, congenital anomalies, no use of antenatal corticosteroids, lower Apgar score, neonatal hypoor hyper-thermia at time of admission and clinical or biochemical signs of respiratory insufficiency [11]. The majority of these prediction models were only applicable after birth as they included predictors that are not known antenatally, like birth weight, SGA

Sign up for access to the world's latest research.

checkGet notified about relevant papers

checkSave papers to use in your research

checkJoin the discussion with peers

checkTrack your impact