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https://hdl.handle.net/10216/111801
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DC Field | Value | Language |
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dc.creator | Smith, LK | - |
dc.creator | Blondel, B | - |
dc.creator | Van Reempts, P | - |
dc.creator | Draper, ES | - |
dc.creator | Manktelow, BN | - |
dc.creator | Barros, H | - |
dc.creator | Cuttini, M | - |
dc.creator | Zeitlin, J | - |
dc.date.accessioned | 2018-05-02T14:49:23Z | - |
dc.date.available | 2018-05-02T14:49:23Z | - |
dc.date.issued | 2017 | - |
dc.identifier.issn | 1359-2998 | - |
dc.identifier.uri | http://hdl.handle.net/10216/111801 | - |
dc.description.abstract | Objective: To explore international variations in the management and survival of extremely low gestational age and birthweight births. Design Area-based prospective cohort of births: Setting 12 regions across Belgium, France, Italy, Portugal and the UK. Participants: 1449 live births and fetal deaths between 22+0 and 25+6 weeks gestation born in 2011–2012. Main outcome measures: Percentage of births; recorded live born; provided antenatal steroids or respiratory support; surviving to discharge (with/without severe morbidities). Results: The percentage of births recorded as live born was consistently low at 22 weeks and consistently high at 25 weeks but varied internationally at 23 weeks for those weighing 500 g and over (range 33%–70%) and at 24 weeks for those under 500 g (range 5%–71%). Antenatal steroids and provision of respiratory support at 22–24 weeks gestation varied between countries, but were consistently high for babies born at 25 weeks. Survival to discharge was universally poor at 22 weeks gestation (0%) and at any gestation with birth weight <500 g, irrespective of treatment provision. In contrast, births at 23 and 24 weeks weighing 500 g and over showed significant international variation in survival (23 weeks: range: 0%–25%; 24 weeks range: 21%–50%), reflecting levels of treatment provision. Conclusions: Wide international variation exists in the management and survival of extremely preterm births at 22–24 weeks gestation. Universally poor outcomes for babies at 22 weeks and for those weighing under 500 g suggest little impact of intervention and support the inclusion of birth weight along with gestational age in ethical decision-making guidelines. | pt_PT |
dc.description.sponsorship | The research leading to these results received funding from the European Union’s Seventh Framework Programme ((FP7/2007–2013)) under grant agreement n°259882. Additional funding was received in the following region: France (French Institute of Public Health Research/Institute of Public Health and its partners the French Health Ministry, the National Institute of Health and Medical Research, the National Institute of Cancer and the National Solidarity Fund for Autonomy; grant ANR-11-EQPX-0038 from the National Research Agency through the French Equipex Program of Investments in the Future and the PremUp Foundation). UK (funding for The Neonatal Survey from Neonatal Networks for East Midlands and Yorkshire and Humber regions). The funders had no role in study design; in the collection, analysis and interpretation of data; in the writing of the report or in the decision to submit the article for publication. LKS is funded by a National Institute for Health Research Career Development Fellowship. This article presents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR or the Department of Health. | pt_PT |
dc.language.iso | eng | pt_PT |
dc.publisher | BMJ | pt_PT |
dc.relation.ispartofseries | Arch Dis Child Fetal Neonatal Ed, vol. 102(5), p. F400-F408 | pt_PT |
dc.rights | openAccess | pt_PT |
dc.subject | Preterm birth - Europe | pt_PT |
dc.title | Variability in the management and outcomes of extremely preterm births across five European countries: a population-based cohort study | pt_PT |
dc.type | Artigo em Revista Científica Internacional | pt_PT |
dc.contributor.uporto | Instituto de Saúde Pública | pt_PT |
dc.identifier.doi | 10.1136/archdischild-2016-312100 | - |
dc.relation.publisherversion | http://fn.bmj.com/content/102/5/F400 | - |
Appears in Collections: | ISPUP - Artigo em Revista Científica Internacional |
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File | Description | Size | Format | |
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Smith1025.pdf | 847.19 kB | Adobe PDF | View/Open |
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