Trends in the survival of very preterm infants between 2011 and 2020 in France.

IF 3.9 2区医学 Q1 PEDIATRICS Archives of Disease in Childhood - Fetal and Neonatal Edition Pub Date : 2024-12-27 DOI:10.1136/archdischild-2024-327814

Victoria Butler, Luc Gaulard, Victor Sartorius, Pierre Yves Ancel, François Goffinet, Jeanne Fresson, Jennifer Zeitlin, Héloïse Torchin

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Abstract

Objective: The objective is to evaluate changes in survival to discharge of liveborn infants less than 32 weeks' gestational age (GA) in France, where the latest available data on very preterm survival at a national-level are from the EPIPAGE-2 (Etude épidémiologique sur les petits âges gestationnels) cohort in 2011.

Design: Population-based cohort study.

Setting: Metropolitan France in 2011, 2015 and 2020.

Patients: All births between 22 and 31 weeks' GA using the EPIPAGE-2 cohort study for the year 2011 and hospital discharge data linked to death certificates from the Système National des Données de Santé for the years 2015 and 2020.

Main outcome measures: The primary outcome was survival to hospital discharge among liveborn infants. Survival rates were compared using modified Poisson regression and adjusted for population characteristics (maternal age, multiple birth, sex, small for GA). Data on all births were examined to assess changes to the live birth rate.

Results: Survival to discharge among live births increased at 23 and 24 weeks' GA from 1% and 31% in 2011 to 8% and 37% in 2015 and to 31% and 47% in 2020, respectively. From 25 to 28 weeks' GA, survival rates tended to increase, but differences were not significant, and survival rates were stable from 29 to 31 weeks GA. Results were similar after adjustment. The proportion of live births versus stillbirths increased from 22 to 24 weeks' GA.

Conclusion: Survival rates among live births improved between 2011 and 2020 from 23 to 28 weeks' GA, with marked changes at 23 and 24 weeks' GA.

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2011年至2020年法国极早产儿的生存趋势。

目的：目的是评估法国小于32周胎龄（GA）的活产婴儿的生存到出院的变化，其中最新的国家级极早产儿生存数据来自2011年EPIPAGE-2 （Etude petits gestationnels研究项目）队列。设计：基于人群的队列研究。背景：2011年、2015年和2020年的法国大都市。患者：使用2011年EPIPAGE-2队列研究的所有出生年龄在22至31周之间的新生儿，以及2015年和2020年来自法国全国唐萨梅斯系统的死亡证明的出院数据。主要结局指标：主要结局指标为活产婴儿的存活至出院。生存率采用修正泊松回归进行比较，并根据种群特征（产妇年龄、多胎、性别、GA小）进行调整。研究人员检查了所有出生数据，以评估活产率的变化。结果：分娩23周和24周时的活产分娩存活率分别从2011年的1%和31%增加到2015年的8%和37%，到2020年分别增加到31%和47%。25 ~ 28周存活率有上升趋势，但差异不显著，29 ~ 31周存活率基本稳定。调整后结果相似。活产与死产的比例从出生时22周增加到24周。结论：2011年至2020年，出生23周至28周的活产婴儿生存率有所提高，其中23周和24周的生存率变化明显。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives of Disease in Childhood - Fetal and Neonatal Edition 医学-小儿科

CiteScore

9.00

自引率

4.50%

发文量

审稿时长

6-12 weeks

期刊介绍： Archives of Disease in Childhood is an international peer review journal that aims to keep paediatricians and others up to date with advances in the diagnosis and treatment of childhood diseases as well as advocacy issues such as child protection. It focuses on all aspects of child health and disease from the perinatal period (in the Fetal and Neonatal edition) through to adolescence. ADC includes original research reports, commentaries, reviews of clinical and policy issues, and evidence reports. Areas covered include: community child health, public health, epidemiology, acute paediatrics, advocacy, and ethics.