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Title: Comparison of prognosis among extremely low birth weight neonates born in the Malopolska region within the years 2002-2004 and 2006-2008

Abstract:

Background: New therapeutic methods in neonatal care and a threelevel perinatal care system have been introduced in Poland in order to decrease the mortality and the incidence of late complications of prematurity among premature neonates. Aims: To assess the impact of new procedures on treatment results in extremely low birth weight infants. The incidence of late complications of prematurity (with a focus on BPD and ROP) and mortality rates were compared among <1000g birth weight neonates in the Malopolska region within the years 2002-2004 and 2006-2008. Additionally risk factors of late complications of prematurity were analyzed as well. Materials and methods: 389 extremely low birth weight neonates were enrolled in the study: 179 children born in 2002-2004, and 210 children born in 2006-2008, which were hospitalized in tertiary care perinatal centres in the Malopolska district. Results: The overall mortality rate was 58%, which hadn't changed within the years 2002-2004 and 2006-2008 among analyzed infants. A reduction in early neonatal death rates from 466‰ to 422,4‰ was found as well as a decrease in perinatal mortality from 605,7‰ to 552‰. An increase in late neonatal mortality was observed in 2006- 2008 compared to 2002-2004 (116,2‰ and 67,9‰). The incidence of bronchopulmonary dysplasia (76% and 76,5%) and moderate to severe BPD (43% and 44%) hadn't ; changed. A similar incidence rate of retinopathy of prematurity requiring laser photocoagulation - 44% was noted. Neonate maturity level and surfactant therapy were independent risk factors of BPD. Delivery outside a perinatal centre was an additional risk factor of BPD in 2006-2008. Child maturity level and duration of oxygen therapy were independent risk factors of ROP. Conclusions: The mortality rate, incidence and risk factors of late complications of prematurity have not changed. The onset of death has shifted from the first week to the next three weeks of life, with the same overall mortality rates in the neonatal period. Improvement in prenatal care, more frequent early surfactant therapy and the usage of noninvasive ventilation techniques are the most important factors that improve prognosis among extremely low birth weight infants in the Malopolska district. The execution of a three-level perinatal care system is also required.

Place of publishing:

Kraków

Level of degree:

2 - studia doktoranckie

Degree discipline:

pediatria

Degree grantor:

Wydział Lekarski

Promoter:

Pietrzyk, Jacek J.

Date issued:

2012

Identifier:

oai:dl.cm-uj.krakow.pl:3610

Call number:

ZB-118308

Language:

pol

Access rights:

tylko w bibliotece

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Last modified:

Apr 11, 2022

In our library since:

Jul 19, 2013

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http://dl.cm-uj.krakow.pl:8080/publication/3610

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ZB-118308 Apr 11, 2022
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