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Preterm birth in the Nordic countries-Capacity, management and outcome in neonatal care

Preterm birth in the Nordic countries-Capacity, management and outcome in neonatal care

Title: Preterm birth in the Nordic countries-Capacity, management and outcome in neonatal care
Author: Norman, Mikael
Padkaer Petersen, Jesper
Stensvold, Hans Jørgen
Þórkelsson, Þórður
Helenius, Kjell
Brix Andersson, Charlotte
Ørum Cueto, Heidi
Domellöf, Magnus
Gissler, Mika
Heino, Anna
... 7 more authors Show all authors
Date: 2023-07
Language: English
Scope: 12
Department: Other departments
Series: Acta paediatrica (Oslo, Norway : 1992); 112(7)
ISSN: 1651-2227
DOI: 10.1111/apa.16753
Subject: Barnalæknisfræði; gestational age; mortality; neonatal care; Nordic country; premature; Infant Mortality; Infant, Premature, Diseases; Humans; Infant; Gestational Age; Scandinavian and Nordic Countries/epidemiology; Pregnancy; Premature Birth/epidemiology; Female; Infant, Extremely Premature; Infant, Newborn; Pediatrics, Perinatology and Child Health
URI: https://hdl.handle.net/20.500.11815/4160

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Norman , M , Padkaer Petersen , J , Stensvold , H J , Þórkelsson , Þ , Helenius , K , Brix Andersson , C , Ørum Cueto , H , Domellöf , M , Gissler , M , Heino , A , Håkansson , S , Jonsson , B , Klingenberg , C , Lehtonen , L , Metsäranta , M , Rønnestad , A E & Trautner , S 2023 , ' Preterm birth in the Nordic countries-Capacity, management and outcome in neonatal care ' , Acta paediatrica (Oslo, Norway : 1992) , vol. 112 , no. 7 , pp. 1422-1433 . https://doi.org/10.1111/apa.16753


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.


Funding Information: Collaborators: Norwegian Neonatal Network: Anlaug Vatne (Stavanger, Bergen), Ragnhild Støen (Trondheim), Kristin Brække (Stavanger), Hallvard Reigstad (Oslo). Swedish Neonatal Quality Register: Lars Navér (Stockholm), Thomas Abrahamsson (Linköping), Karin Sävman (Göteborg), Ylva Thernström Blomqvist (Uppsala), Johan Sandblom (Skåne), Fredrik Ingemansson (Jönköping). Finnish Very Preterm Infant Register collaboration group: Timo Saarela (Oulu), Päivi Korhonen (Tampere), Ulla Sankilampi (Kuopio), Viena Tommiska (Helsinki), Samuli Rautava (Turku). We thank all neonatal departments in the Nordic countries for contributing and sharing data to our national registers. The creation and completion of the Nordic quality registers have been the work of many and taken decades. To thank all relevant parties would be impossible, none mentioned none forgotten. Funding Information: MN was supported by grants from a regional agreement on clinical research (ALF) between Region Stockholm and Karolinska Institutet (2020‐0443), and from the Childhood Foundation of the Swedish Order of Freemasons. The funding bodies played no role in any aspect of the study or the paper. Publisher Copyright: © 2023 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.

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