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Outcomes and resource usage of infants born at ≤ 25 weeks gestation in Canada
Paediatrics and Child Health (Canada)
  • Amy Shafey, University of Toronto
  • Rani Ameena Bashir, University of Calgary
  • Prakesh Shah, University of Toronto
  • Anne Synnes, The University of British Columbia
  • Junmin Yang, Mount Sinai Hospital of University of Toronto
  • Edmond N. Kelly, University of Toronto
  • Prakesh S. Shah
  • Adele Harrison
  • Joseph Ting
  • Wendy Yee
  • Khalid Aziz
  • Jennifer Toye
  • Carlos Fajardo
  • Zarin Kalapesi
  • Koravangattu Sankaran
  • Sibasis Daspal
  • Mary Seshia
  • Ruben Alvaro
  • Sandesh Shivananda
  • Orlando Da Silva
  • Chuks Nwaesei
  • Kyong Soon Lee
  • Michael Dunn
  • Brigitte Lemyre
  • Kimberly Dow
  • Ermelinda Pelausa
  • Keith Barrington
  • Christine Drolet
  • Bruno Piedboeuf
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Objectives: To determine the outcomes and resource usage of infants born at ≤ 25 weeks gestational age (GA). Methods: Retrospective study of infants born between April 2009 and September 2011 at ≤ 25 weeks' GA in all neonatal intensive care units in Canada with follow-up in the neonatal follow-up clinics. Short-term morbidities, neurodevelopmental impairment, significant neurodevelopmental impairment, and resource utilization of infants born at ≤ 24 weeks were compared with neonates born at 25 weeks. Results: Of 803 neonates discharged alive, 636 (80.4%) infants born at ≤ 25 weeks' GA were assessed at 18 to 24 months. Caesarean delivery, lower birth weight, and less antenatal steroid exposure were more common in infants born ≤ 24 weeks as compared with 25 weeks. They had significantly higher incidences of ductus arteriosus ligation, severe intracranial hemorrhage, retinopathy of prematurity as well as longer length of stay, central line days, days on respiratory support, days on total parenteral nutrition, days on antibiotics, and need for postnatal steroids. Neurodevelopmental impairment rates were 68.9, 64.5, and 55.6% (P=0.01) and significant neurodevelopmental impairment rates were 39.3, 29.6, and 20.9% (P<0.01) for infants ≤ 23, 24, and 25 weeks GA, respectively. Postdischarge service referrals were higher for those ≤ 23 weeks. Nonsurviving infants born at 25 weeks GA had higher resource utilization during admission than infants born less than 25 weeks. Conclusions: Adverse outcomes and resource usage were significantly higher among infants born ≤ 24 weeks GA as compared with 25 weeks GA.

Citation Information
Amy Shafey, Rani Ameena Bashir, Prakesh Shah, Anne Synnes, et al.. "Outcomes and resource usage of infants born at ≤ 25 weeks gestation in Canada" Paediatrics and Child Health (Canada) Vol. 25 Iss. 4 (2020) p. 207 - 215
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