Comparison Of Outcomes Amoung Infants Admitted to Nicus in Canada During 2006–2007 and 1996–1997

Abstract

Background: It is plausible that advances in neonatal intensive care in the last 10 years have resulted in significant reductions in mortality and morbidities for very preterm infants. A concern is that improved survival might result in an increased number of infants with morbidities. Objective: To compare neonatal outcomes of infants born at < 28 weeks gestation during 2006-2007 (22 months period) and 1996-1997 (22 months period) admitted to the same 15 centers in the Canadian Neonatal Network (CNN). Design/Methods: Demographic information, severity of illness on admission (using SNAP II), and perinatal risks were compared for baseline similarity. Rates of mortality, chronic lung disease at 36 weeks (CLD), significant brain injury, and ROP >stage 2 were compared using univariate and multivariable logistic regression analyses. Results: A total of 1866 infants were eligible in 2006-7 and 1897 in 1996-97 respectively. Baseline comparison revealed a higher number of infants in the 1996-7 cohort who were born vaginally, had not received antenatal steroids, and had higher SNAP II scores compared to the 2006-7 cohort. Results of univariate and multivariable analyses for important neonatal outcomes are presented in the table. (Table presented) Conclusions: There was no significant change in adjusted risks of mortality or severe ROP between 10 years apart cohorts. There was an increase in CLD in 2006-7. The increase in neurological injury in the 2006-7 cohort could be due to differences in classification and improved rates of detection. The lack of improvement in survival and an increase in CLD are of concern. A similar comparison of longer-term outcomes is warranted.