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Changes in management policies for extremely preterm births and neonatal outcomes from 2003 to 2012: two population-based studies in 10 European regions

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Bonet, M, Cuttini, M, Piedvache, A, Boyle, EM, Jarreau, P-H, Kollée, L, Maier, RF, Milligan, DWA, Van Reempts, P, Weber, T, Barros, H, Gadzinowki, J, Draper, ES, Zeitlin, J & MOSAIC AND EPICE research groups 2017, 'Changes in management policies for extremely preterm births and neonatal outcomes from 2003 to 2012: two population-based studies in 10 European regions' BJOG : an international journal of obstetrics and gynaecology, bind 124, nr. 10, s. 1595-1604. https://doi.org/10.1111/1471-0528.14639

APA

CBE

Bonet M, Cuttini M, Piedvache A, Boyle EM, Jarreau P-H, Kollée L, Maier RF, Milligan DWA, Van Reempts P, Weber T, Barros H, Gadzinowki J, Draper ES, Zeitlin J, MOSAIC AND EPICE research groups. 2017. Changes in management policies for extremely preterm births and neonatal outcomes from 2003 to 2012: two population-based studies in 10 European regions. BJOG : an international journal of obstetrics and gynaecology. 124(10):1595-1604. https://doi.org/10.1111/1471-0528.14639

MLA

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Author

Bonet, Mercedes ; Cuttini, M ; Piedvache, A ; Boyle, Elaine M ; Jarreau, Pierre-Henri ; Kollée, L ; Maier, R F ; Milligan, D W A ; Van Reempts, P ; Weber, T ; Barros, Henrique ; Gadzinowki, J ; Draper, E S ; Zeitlin, J ; MOSAIC AND EPICE research groups. / Changes in management policies for extremely preterm births and neonatal outcomes from 2003 to 2012 : two population-based studies in 10 European regions. I: BJOG : an international journal of obstetrics and gynaecology. 2017 ; Bind 124, Nr. 10. s. 1595-1604.

Bibtex

@article{cee1135b168f49799176131afc59c283,
title = "Changes in management policies for extremely preterm births and neonatal outcomes from 2003 to 2012: two population-based studies in 10 European regions",
abstract = "OBJECTIVE: to investigate changes in maternity and neonatal unit policies towards extremely preterm infants (EPTI) between 2003 and 2012 and concurrent trends in their mortality and morbidity in ten European regions.DESIGN: population-based cohort studies in 2003 (MOSAIC study) and 2011/12 (EPICE study) and questionnaires from hospitals.SETTING: 70 hospitals in ten European regions.POPULATION: infants born at <27 weeks of gestational age (GA) in hospitals participating in both the MOSAIC and EPICE studies (1240 in 2003, 1293 in 2011/2012).METHODS: We used McNemar's Chi2 test, paired t-tests and conditional logistic regression for comparisons over time.MAIN OUTCOMES MEASURES: reported policies, mortality and morbidity of EPTI.RESULTS: The lowest GA at which maternity units reported performing a caesarean section for acute distress of a singleton non-malformed fetus decreased from an average of 24.7 to 24.1 weeks (p<0.01) when parents were in favour of active management and 26.1 to 25.2 (p=0.01) when parents were against. Units reported that neonatologists were called more often for spontaneous deliveries starting at 22 weeks GA in 2012 and more often made decisions about active resuscitation alone, rather than in multidisciplinary teams. In-hospital mortality after live birth for EPTI decreased from 50{\%} to 42{\%} (p<0.01). Units reporting more active management in 2012 than 2003 had higher mortality in 2003 (55{\%} vs. 43{\%}, p<.01) and experienced larger declines (55{\%} to 44{\%}; p<0.001) than units where policies stayed the same (43{\%} to 37{\%}; p=0.1).CONCLUSIONS: European hospitals reporting changes in management policies experienced larger survival gains for EPTI. This article is protected by copyright. All rights reserved.",
keywords = "Journal Article",
author = "Mercedes Bonet and M Cuttini and A Piedvache and Boyle, {Elaine M} and Pierre-Henri Jarreau and L Koll{\'e}e and Maier, {R F} and Milligan, {D W A} and {Van Reempts}, P and T Weber and Henrique Barros and J Gadzinowki and Draper, {E S} and J Zeitlin and {MOSAIC AND EPICE research groups}",
note = "This article is protected by copyright. All rights reserved.",
year = "2017",
month = "9",
day = "1",
doi = "10.1111/1471-0528.14639",
language = "English",
volume = "124",
pages = "1595--1604",
journal = "BJOG: An International Journal of Obstetrics and Gynaecology",
issn = "1470-0328",
publisher = "Wiley-Blackwell Publishing Ltd",
number = "10",

}

RIS

TY - JOUR

T1 - Changes in management policies for extremely preterm births and neonatal outcomes from 2003 to 2012

T2 - two population-based studies in 10 European regions

AU - Bonet, Mercedes

AU - Cuttini, M

AU - Piedvache, A

AU - Boyle, Elaine M

AU - Jarreau, Pierre-Henri

AU - Kollée, L

AU - Maier, R F

AU - Milligan, D W A

AU - Van Reempts, P

AU - Weber, T

AU - Barros, Henrique

AU - Gadzinowki, J

AU - Draper, E S

AU - Zeitlin, J

AU - MOSAIC AND EPICE research groups

N1 - This article is protected by copyright. All rights reserved.

PY - 2017/9/1

Y1 - 2017/9/1

N2 - OBJECTIVE: to investigate changes in maternity and neonatal unit policies towards extremely preterm infants (EPTI) between 2003 and 2012 and concurrent trends in their mortality and morbidity in ten European regions.DESIGN: population-based cohort studies in 2003 (MOSAIC study) and 2011/12 (EPICE study) and questionnaires from hospitals.SETTING: 70 hospitals in ten European regions.POPULATION: infants born at <27 weeks of gestational age (GA) in hospitals participating in both the MOSAIC and EPICE studies (1240 in 2003, 1293 in 2011/2012).METHODS: We used McNemar's Chi2 test, paired t-tests and conditional logistic regression for comparisons over time.MAIN OUTCOMES MEASURES: reported policies, mortality and morbidity of EPTI.RESULTS: The lowest GA at which maternity units reported performing a caesarean section for acute distress of a singleton non-malformed fetus decreased from an average of 24.7 to 24.1 weeks (p<0.01) when parents were in favour of active management and 26.1 to 25.2 (p=0.01) when parents were against. Units reported that neonatologists were called more often for spontaneous deliveries starting at 22 weeks GA in 2012 and more often made decisions about active resuscitation alone, rather than in multidisciplinary teams. In-hospital mortality after live birth for EPTI decreased from 50% to 42% (p<0.01). Units reporting more active management in 2012 than 2003 had higher mortality in 2003 (55% vs. 43%, p<.01) and experienced larger declines (55% to 44%; p<0.001) than units where policies stayed the same (43% to 37%; p=0.1).CONCLUSIONS: European hospitals reporting changes in management policies experienced larger survival gains for EPTI. This article is protected by copyright. All rights reserved.

AB - OBJECTIVE: to investigate changes in maternity and neonatal unit policies towards extremely preterm infants (EPTI) between 2003 and 2012 and concurrent trends in their mortality and morbidity in ten European regions.DESIGN: population-based cohort studies in 2003 (MOSAIC study) and 2011/12 (EPICE study) and questionnaires from hospitals.SETTING: 70 hospitals in ten European regions.POPULATION: infants born at <27 weeks of gestational age (GA) in hospitals participating in both the MOSAIC and EPICE studies (1240 in 2003, 1293 in 2011/2012).METHODS: We used McNemar's Chi2 test, paired t-tests and conditional logistic regression for comparisons over time.MAIN OUTCOMES MEASURES: reported policies, mortality and morbidity of EPTI.RESULTS: The lowest GA at which maternity units reported performing a caesarean section for acute distress of a singleton non-malformed fetus decreased from an average of 24.7 to 24.1 weeks (p<0.01) when parents were in favour of active management and 26.1 to 25.2 (p=0.01) when parents were against. Units reported that neonatologists were called more often for spontaneous deliveries starting at 22 weeks GA in 2012 and more often made decisions about active resuscitation alone, rather than in multidisciplinary teams. In-hospital mortality after live birth for EPTI decreased from 50% to 42% (p<0.01). Units reporting more active management in 2012 than 2003 had higher mortality in 2003 (55% vs. 43%, p<.01) and experienced larger declines (55% to 44%; p<0.001) than units where policies stayed the same (43% to 37%; p=0.1).CONCLUSIONS: European hospitals reporting changes in management policies experienced larger survival gains for EPTI. This article is protected by copyright. All rights reserved.

KW - Journal Article

U2 - 10.1111/1471-0528.14639

DO - 10.1111/1471-0528.14639

M3 - Journal article

VL - 124

SP - 1595

EP - 1604

JO - BJOG: An International Journal of Obstetrics and Gynaecology

JF - BJOG: An International Journal of Obstetrics and Gynaecology

SN - 1470-0328

IS - 10

ER -

ID: 50108413