Outcomes and resource usage of infants born at ≤ 25 weeks gestation in Canada

Amy Shafey; Rani Ameena Bashir; Prakesh Shah; Anne Synnes; Junmin Yang; Edmond N. Kelly; Prakesh S. Shah; Adele Harrison; Joseph Ting; Wendy Yee; Khalid Aziz; Jennifer Toye; Carlos Fajardo; Zarin Kalapesi; Koravangattu Sankaran; Sibasis Daspal; Mary Seshia; Ruben Alvaro; Sandesh Shivananda; Orlando Da Silva; Chuks Nwaesei; Kyong Soon Lee; Michael Dunn; Brigitte Lemyre; Kimberly Dow; Ermelinda Pelausa; Keith Barrington; Christine Drolet; Bruno Piedboeuf; Martine Claveau; Daniel Faucher; Valerie Bertelle; Edith Masse; Roderick Canning; Hala Makary; Cecil Ojah; Luis Monterrosa; Akhil Deshpandey; Jehier Afifi; Andrzej Kajetanowicz; Shoo K. Lee; Thevanisha Pillay; Reg Sauvé; Leonora Hendson; Amber Reichert; Jaya Bodani; DIane Moddemann; Thierry Daboval; David Lee; Linh Ly; Salhab El Helou; Paige Church; Patricia Riley; Francine Levebrve; Charlotte Demers; Sylvie Bélanger; Michael Vincer; Phil Murphy

doi:10.1093/pch/pxz002

Outcomes and resource usage of infants born at ≤ 25 weeks gestation in Canada

Amy Shafey, Rani Ameena Bashir, Prakesh Shah, Anne Synnes, Junmin Yang, Edmond N. Kelly, Prakesh S. Shah, Adele Harrison, Joseph Ting, Wendy Yee, Khalid Aziz, Jennifer Toye, Carlos Fajardo, Zarin Kalapesi, Koravangattu Sankaran, Sibasis Daspal, Mary Seshia, Ruben Alvaro, Sandesh Shivananda, Orlando Da SilvaChuks Nwaesei, Kyong Soon Lee, Michael Dunn, Brigitte Lemyre, Kimberly Dow, Ermelinda Pelausa, Keith Barrington, Christine Drolet, Bruno Piedboeuf, Martine Claveau, Daniel Faucher, Valerie Bertelle, Edith Masse, Roderick Canning, Hala Makary, Cecil Ojah, Luis Monterrosa, Akhil Deshpandey, Jehier Afifi, Andrzej Kajetanowicz, Shoo K. Lee, Thevanisha Pillay, Reg Sauvé, Leonora Hendson, Amber Reichert, Jaya Bodani, DIane Moddemann, Thierry Daboval, David Lee, Linh Ly, Salhab El Helou, Paige Church, Patricia Riley, Francine Levebrve, Charlotte Demers, Sylvie Bélanger, Michael Vincer, Phil Murphy

Medicine

Résultat de recherche: Article › examen par les pairs

7 Citations (Scopus)

Résumé

Objectives: To determine the outcomes and resource usage of infants born at ≤ 25 weeks gestational age (GA). Methods: Retrospective study of infants born between April 2009 and September 2011 at ≤ 25 weeks' GA in all neonatal intensive care units in Canada with follow-up in the neonatal follow-up clinics. Short-term morbidities, neurodevelopmental impairment, significant neurodevelopmental impairment, and resource utilization of infants born at ≤ 24 weeks were compared with neonates born at 25 weeks. Results: Of 803 neonates discharged alive, 636 (80.4%) infants born at ≤ 25 weeks' GA were assessed at 18 to 24 months. Caesarean delivery, lower birth weight, and less antenatal steroid exposure were more common in infants born ≤ 24 weeks as compared with 25 weeks. They had significantly higher incidences of ductus arteriosus ligation, severe intracranial hemorrhage, retinopathy of prematurity as well as longer length of stay, central line days, days on respiratory support, days on total parenteral nutrition, days on antibiotics, and need for postnatal steroids. Neurodevelopmental impairment rates were 68.9, 64.5, and 55.6% (P=0.01) and significant neurodevelopmental impairment rates were 39.3, 29.6, and 20.9% (P<0.01) for infants ≤ 23, 24, and 25 weeks GA, respectively. Postdischarge service referrals were higher for those ≤ 23 weeks. Nonsurviving infants born at 25 weeks GA had higher resource utilization during admission than infants born less than 25 weeks. Conclusions: Adverse outcomes and resource usage were significantly higher among infants born ≤ 24 weeks GA as compared with 25 weeks GA.

Langue d'origine	English
Pages (de-à)	207-215
Nombre de pages	9
Journal	Paediatrics and Child Health
Volume	25
Numéro de publication	4
DOI	https://doi.org/10.1093/pch/pxz002
Statut de publication	Published - juin 10 2020

Note bibliographique

Funding Information:
Funding Information: Organizational support was provided by the Maternal-Infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto, which is supported by a Canadian Institutes of Health Research (CIHR) Team Grant (FRN87518). PS holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research awarded by the CIHR (APR-126340). The funding bodies had no role in the design of the study, collection and analysis of data and decision to publish this manuscript.

Publisher Copyright:
© 2019 The Author(s) 2019. Published by Oxford University Press on behalf of the Canadian Paediatric Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

ASJC Scopus Subject Areas

Pediatrics, Perinatology, and Child Health

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10.1093/pch/pxz002

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Shafey, A., Bashir, R. A., Shah, P., Synnes, A., Yang, J., Kelly, E. N., Shah, P. S., Harrison, A., Ting, J., Yee, W., Aziz, K., Toye, J., Fajardo, C., Kalapesi, Z., Sankaran, K., Daspal, S., Seshia, M., Alvaro, R., Shivananda, S., ... Murphy, P. (2020). Outcomes and resource usage of infants born at ≤ 25 weeks gestation in Canada. Paediatrics and Child Health, 25(4), 207-215. https://doi.org/10.1093/pch/pxz002

Shafey, A, Bashir, RA, Shah, P, Synnes, A, Yang, J, Kelly, EN, Shah, PS, Harrison, A, Ting, J, Yee, W, Aziz, K, Toye, J, Fajardo, C, Kalapesi, Z, Sankaran, K, Daspal, S, Seshia, M, Alvaro, R, Shivananda, S, Da Silva, O, Nwaesei, C, Lee, KS, Dunn, M, Lemyre, B, Dow, K, Pelausa, E, Barrington, K, Drolet, C, Piedboeuf, B, Claveau, M, Faucher, D, Bertelle, V, Masse, E, Canning, R, Makary, H, Ojah, C, Monterrosa, L, Deshpandey, A, Afifi, J, Kajetanowicz, A, Lee, SK, Pillay, T, Sauvé, R, Hendson, L, Reichert, A, Bodani, J, Moddemann, DI, Daboval, T, Lee, D, Ly, L, El Helou, S, Church, P, Riley, P, Levebrve, F, Demers, C, Bélanger, S, Vincer, M & Murphy, P 2020, 'Outcomes and resource usage of infants born at ≤ 25 weeks gestation in Canada', Paediatrics and Child Health, vol. 25, n° 4, pp. 207-215. https://doi.org/10.1093/pch/pxz002

@article{0ac9bd94f7784b548ffab6eec50e81ee,

title = "Outcomes and resource usage of infants born at ≤ 25 weeks gestation in Canada",

abstract = "Objectives: To determine the outcomes and resource usage of infants born at ≤ 25 weeks gestational age (GA). Methods: Retrospective study of infants born between April 2009 and September 2011 at ≤ 25 weeks' GA in all neonatal intensive care units in Canada with follow-up in the neonatal follow-up clinics. Short-term morbidities, neurodevelopmental impairment, significant neurodevelopmental impairment, and resource utilization of infants born at ≤ 24 weeks were compared with neonates born at 25 weeks. Results: Of 803 neonates discharged alive, 636 (80.4%) infants born at ≤ 25 weeks' GA were assessed at 18 to 24 months. Caesarean delivery, lower birth weight, and less antenatal steroid exposure were more common in infants born ≤ 24 weeks as compared with 25 weeks. They had significantly higher incidences of ductus arteriosus ligation, severe intracranial hemorrhage, retinopathy of prematurity as well as longer length of stay, central line days, days on respiratory support, days on total parenteral nutrition, days on antibiotics, and need for postnatal steroids. Neurodevelopmental impairment rates were 68.9, 64.5, and 55.6% (P=0.01) and significant neurodevelopmental impairment rates were 39.3, 29.6, and 20.9% (P<0.01) for infants ≤ 23, 24, and 25 weeks GA, respectively. Postdischarge service referrals were higher for those ≤ 23 weeks. Nonsurviving infants born at 25 weeks GA had higher resource utilization during admission than infants born less than 25 weeks. Conclusions: Adverse outcomes and resource usage were significantly higher among infants born ≤ 24 weeks GA as compared with 25 weeks GA. ",

author = "Amy Shafey and Bashir, {Rani Ameena} and Prakesh Shah and Anne Synnes and Junmin Yang and Kelly, {Edmond N.} and Shah, {Prakesh S.} and Adele Harrison and Joseph Ting and Wendy Yee and Khalid Aziz and Jennifer Toye and Carlos Fajardo and Zarin Kalapesi and Koravangattu Sankaran and Sibasis Daspal and Mary Seshia and Ruben Alvaro and Sandesh Shivananda and {Da Silva}, Orlando and Chuks Nwaesei and Lee, {Kyong Soon} and Michael Dunn and Brigitte Lemyre and Kimberly Dow and Ermelinda Pelausa and Keith Barrington and Christine Drolet and Bruno Piedboeuf and Martine Claveau and Daniel Faucher and Valerie Bertelle and Edith Masse and Roderick Canning and Hala Makary and Cecil Ojah and Luis Monterrosa and Akhil Deshpandey and Jehier Afifi and Andrzej Kajetanowicz and Lee, {Shoo K.} and Thevanisha Pillay and Reg Sauv{\'e} and Leonora Hendson and Amber Reichert and Jaya Bodani and DIane Moddemann and Thierry Daboval and David Lee and Linh Ly and {El Helou}, Salhab and Paige Church and Patricia Riley and Francine Levebrve and Charlotte Demers and Sylvie B{\'e}langer and Michael Vincer and Phil Murphy",

note = "Funding Information: Funding Information: Organizational support was provided by the Maternal-Infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto, which is supported by a Canadian Institutes of Health Research (CIHR) Team Grant (FRN87518). PS holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research awarded by the CIHR (APR-126340). The funding bodies had no role in the design of the study, collection and analysis of data and decision to publish this manuscript. Publisher Copyright: {\textcopyright} 2019 The Author(s) 2019. Published by Oxford University Press on behalf of the Canadian Paediatric Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.",

year = "2020",

month = jun,

day = "10",

doi = "10.1093/pch/pxz002",

language = "English",

volume = "25",

pages = "207--215",

journal = "Paediatrics and Child Health",

issn = "1205-7088",

publisher = "Pulsus Group Inc.",

number = "4",

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TY - JOUR

T1 - Outcomes and resource usage of infants born at ≤ 25 weeks gestation in Canada

AU - Shafey, Amy

AU - Bashir, Rani Ameena

AU - Shah, Prakesh

AU - Synnes, Anne

AU - Yang, Junmin

AU - Kelly, Edmond N.

AU - Shah, Prakesh S.

AU - Harrison, Adele

AU - Ting, Joseph

AU - Yee, Wendy

AU - Aziz, Khalid

AU - Toye, Jennifer

AU - Fajardo, Carlos

AU - Kalapesi, Zarin

AU - Sankaran, Koravangattu

AU - Daspal, Sibasis

AU - Seshia, Mary

AU - Alvaro, Ruben

AU - Shivananda, Sandesh

AU - Da Silva, Orlando

AU - Nwaesei, Chuks

AU - Lee, Kyong Soon

AU - Dunn, Michael

AU - Lemyre, Brigitte

AU - Dow, Kimberly

AU - Pelausa, Ermelinda

AU - Barrington, Keith

AU - Drolet, Christine

AU - Piedboeuf, Bruno

AU - Claveau, Martine

AU - Faucher, Daniel

AU - Bertelle, Valerie

AU - Masse, Edith

AU - Canning, Roderick

AU - Makary, Hala

AU - Ojah, Cecil

AU - Monterrosa, Luis

AU - Deshpandey, Akhil

AU - Afifi, Jehier

AU - Kajetanowicz, Andrzej

AU - Lee, Shoo K.

AU - Pillay, Thevanisha

AU - Sauvé, Reg

AU - Hendson, Leonora

AU - Reichert, Amber

AU - Bodani, Jaya

AU - Moddemann, DIane

AU - Daboval, Thierry

AU - Lee, David

AU - Ly, Linh

AU - El Helou, Salhab

AU - Church, Paige

AU - Riley, Patricia

AU - Levebrve, Francine

AU - Demers, Charlotte

AU - Bélanger, Sylvie

AU - Vincer, Michael

AU - Murphy, Phil

N1 - Funding Information: Funding Information: Organizational support was provided by the Maternal-Infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto, which is supported by a Canadian Institutes of Health Research (CIHR) Team Grant (FRN87518). PS holds an Applied Research Chair in Reproductive and Child Health Services and Policy Research awarded by the CIHR (APR-126340). The funding bodies had no role in the design of the study, collection and analysis of data and decision to publish this manuscript. Publisher Copyright: © 2019 The Author(s) 2019. Published by Oxford University Press on behalf of the Canadian Paediatric Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

PY - 2020/6/10

Y1 - 2020/6/10

N2 - Objectives: To determine the outcomes and resource usage of infants born at ≤ 25 weeks gestational age (GA). Methods: Retrospective study of infants born between April 2009 and September 2011 at ≤ 25 weeks' GA in all neonatal intensive care units in Canada with follow-up in the neonatal follow-up clinics. Short-term morbidities, neurodevelopmental impairment, significant neurodevelopmental impairment, and resource utilization of infants born at ≤ 24 weeks were compared with neonates born at 25 weeks. Results: Of 803 neonates discharged alive, 636 (80.4%) infants born at ≤ 25 weeks' GA were assessed at 18 to 24 months. Caesarean delivery, lower birth weight, and less antenatal steroid exposure were more common in infants born ≤ 24 weeks as compared with 25 weeks. They had significantly higher incidences of ductus arteriosus ligation, severe intracranial hemorrhage, retinopathy of prematurity as well as longer length of stay, central line days, days on respiratory support, days on total parenteral nutrition, days on antibiotics, and need for postnatal steroids. Neurodevelopmental impairment rates were 68.9, 64.5, and 55.6% (P=0.01) and significant neurodevelopmental impairment rates were 39.3, 29.6, and 20.9% (P<0.01) for infants ≤ 23, 24, and 25 weeks GA, respectively. Postdischarge service referrals were higher for those ≤ 23 weeks. Nonsurviving infants born at 25 weeks GA had higher resource utilization during admission than infants born less than 25 weeks. Conclusions: Adverse outcomes and resource usage were significantly higher among infants born ≤ 24 weeks GA as compared with 25 weeks GA.

AB - Objectives: To determine the outcomes and resource usage of infants born at ≤ 25 weeks gestational age (GA). Methods: Retrospective study of infants born between April 2009 and September 2011 at ≤ 25 weeks' GA in all neonatal intensive care units in Canada with follow-up in the neonatal follow-up clinics. Short-term morbidities, neurodevelopmental impairment, significant neurodevelopmental impairment, and resource utilization of infants born at ≤ 24 weeks were compared with neonates born at 25 weeks. Results: Of 803 neonates discharged alive, 636 (80.4%) infants born at ≤ 25 weeks' GA were assessed at 18 to 24 months. Caesarean delivery, lower birth weight, and less antenatal steroid exposure were more common in infants born ≤ 24 weeks as compared with 25 weeks. They had significantly higher incidences of ductus arteriosus ligation, severe intracranial hemorrhage, retinopathy of prematurity as well as longer length of stay, central line days, days on respiratory support, days on total parenteral nutrition, days on antibiotics, and need for postnatal steroids. Neurodevelopmental impairment rates were 68.9, 64.5, and 55.6% (P=0.01) and significant neurodevelopmental impairment rates were 39.3, 29.6, and 20.9% (P<0.01) for infants ≤ 23, 24, and 25 weeks GA, respectively. Postdischarge service referrals were higher for those ≤ 23 weeks. Nonsurviving infants born at 25 weeks GA had higher resource utilization during admission than infants born less than 25 weeks. Conclusions: Adverse outcomes and resource usage were significantly higher among infants born ≤ 24 weeks GA as compared with 25 weeks GA.

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U2 - 10.1093/pch/pxz002

DO - 10.1093/pch/pxz002

M3 - Article

AN - SCOPUS:85094859818

SN - 1205-7088

VL - 25

SP - 207

EP - 215

JO - Paediatrics and Child Health

JF - Paediatrics and Child Health

IS - 4

ER -

Outcomes and resource usage of infants born at ≤ 25 weeks gestation in Canada

Résumé

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