TY - JOUR
T1 - Preterm birth in the Nordic countries - Capacity, management and outcome in neonatal care
AU - Norman, Mikael
AU - Petersen, Jesper Padkær
AU - Stenvold, Hans Jørgen
AU - Thorkelsson, Thordur
AU - Helenius, Kjell
AU - Andersson, Charlotte Brix
AU - Cueto, Heidi Theresa Ørum
AU - Domellöf, Magnus
AU - Gissler, Mika
AU - Heino, Anna
AU - Håkansson, Stellan
AU - Jonsson, Baldvin
AU - Klingenberg, Claus
AU - Kellokumpu-Lehtinen, Pirkko-Liisa
AU - Metsäranta, Marjo
AU - Rønnestad, Arild E.
AU - Trautner, Simon
PY - 2023/7
Y1 - 2023/7
N2 - Aim: Organisation of care, perinatal and neonatal management of very preterm infants in the Nordic regions were hypothesised to vary significantly. The aim of this observational study was to test this hypothesis. Methods: Information on preterm infants in the 21 greater healthcare regions of Denmark, Finland, Iceland, Norway and Sweden was gathered from national registers in 2021. Preterm birth rates, case-mix, perinatal interventions, neonatal morbidity and survival to hospital discharge in very (<32 weeks) and extremely preterm infants (<28 weeks of gestational age) were compared. Results: Out of 287 642 infants born alive, 16 567 (5.8%) were preterm, 2389 (0.83%) very preterm and 800 (0.28%) were extremely preterm. In very preterm infants, exposure to antenatal corticosteroids varied from 85% to 98%, live births occurring at regional centres from 48% to 100%, surfactant treatment from 28% to 69% and use of mechanical ventilation varied from 13% to 77% (p < 0.05 for all comparisons). Significant regional variations within and between countries were also seen in capacity in neonatal care, case-mix and number of admissions, whereas there were no statistically significant differences in survival or major neonatal morbidities. Conclusion: Management of very preterm infants exhibited significant regional variations in the Nordic countries.
AB - Aim: Organisation of care, perinatal and neonatal management of very preterm infants in the Nordic regions were hypothesised to vary significantly. The aim of this observational study was to test this hypothesis. Methods: Information on preterm infants in the 21 greater healthcare regions of Denmark, Finland, Iceland, Norway and Sweden was gathered from national registers in 2021. Preterm birth rates, case-mix, perinatal interventions, neonatal morbidity and survival to hospital discharge in very (<32 weeks) and extremely preterm infants (<28 weeks of gestational age) were compared. Results: Out of 287 642 infants born alive, 16 567 (5.8%) were preterm, 2389 (0.83%) very preterm and 800 (0.28%) were extremely preterm. In very preterm infants, exposure to antenatal corticosteroids varied from 85% to 98%, live births occurring at regional centres from 48% to 100%, surfactant treatment from 28% to 69% and use of mechanical ventilation varied from 13% to 77% (p < 0.05 for all comparisons). Significant regional variations within and between countries were also seen in capacity in neonatal care, case-mix and number of admissions, whereas there were no statistically significant differences in survival or major neonatal morbidities. Conclusion: Management of very preterm infants exhibited significant regional variations in the Nordic countries.
KW - Nordic country
KW - gestational age
KW - mortality
KW - neonatal care
KW - premature
UR - http://www.scopus.com/inward/record.url?scp=85150900950&partnerID=8YFLogxK
U2 - 10.1111/apa.16753
DO - 10.1111/apa.16753
M3 - Journal article
SN - 1651-2227
VL - 112
SP - 1422
EP - 1433
JO - Acta Pædiatrica
JF - Acta Pædiatrica
IS - 7
ER -