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Olhager, Elisabeth
Publications (10 of 20) Show all publications
Olhager, E. & Törnqvist, C. (2014). Body composition in late preterm infants in the first 10 days of life and at full term. Acta Paediatrica, 103(7), 737-743
Open this publication in new window or tab >>Body composition in late preterm infants in the first 10 days of life and at full term
2014 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, no 7, p. 737-743Article in journal (Refereed) Published
Abstract [en]

AIM:

To investigate changes in body weight, fat-free mass, fat mass and percentage of body fat during early life and at full-term postconceptional age (PCA) in preterm infants born after 32 gestational weeks and before 37.

METHODS:

Twenty-nine late preterm infants underwent growth and body composition assessment by air displacement plethysmography (ADP) at the age of 4 days and at full-term PCA. In 25 of these infants, body composition was assessed three times between days four and nine of life. The preterm infants were compared with 29 full-term infants, matched for gestational age, sex and body weight.

RESULTS:

There was a significant increase in birth weight and fat-free mass between days four and nine of life. Preterm infants had significantly more body fat 382 ± 180 g vs 287 ± 160 g than full-term infants at full-term PCA. Preterm infants showed poor linear growth between birth and full-term PCA.

CONCLUSION:

Weight gain after the initial postnatal weight loss consists of gain in fat-free mass. At full-term PCA, preterm infants were stunted. When compared with full-term new born infants matched for body weight and gestational age, preterm infants had more body fat and a higher percentage of body fat.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2014
Keyword
Air displacement plethysmography; Body composition; Fat mass; Fat-free mass; Preterm infants
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-109118 (URN)10.1111/apa.12632 (DOI)000337572700022 ()24628453 (PubMedID)
Available from: 2014-08-13 Created: 2014-08-11 Last updated: 2017-12-05Bibliographically approved
Serenius, F., Sjors, G., Blennow, M., Fellman, V., Holmstrom, G., Marsal, K., . . . Kallen, K. (2014). EXPRESS study shows significant regional differences in 1-year outcome of extremely preterm infants in Sweden. Acta Paediatrica, 103(1), 27-37
Open this publication in new window or tab >>EXPRESS study shows significant regional differences in 1-year outcome of extremely preterm infants in Sweden
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2014 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, no 1, p. 27-37Article in journal (Refereed) Published
Abstract [en]

AimThe aim of this study was to investigate differences in mortality up to 1year of age in extremely preterm infants (before 27weeks) born in seven Swedish healthcare regions. MethodsNational prospective observational study of consecutively born, extremely preterm infants in Sweden 2004-2007. Mortality was compared between regions. Crude and adjusted odds ratios and 95% CI were calculated. ResultsAmong 844 foetuses alive at mothers admission for delivery, regional differences were identified in perinatal mortality for the total group (22-26weeks) and in the stillbirth and perinatal and 365-day mortality rates for the subgroup born at 22-24weeks. Among 707 infants born alive, regional differences were found both in mortality before 12h and in the 365-day mortality rate for the subgroup (22-24weeks) and for the total group (22-26weeks). The mortality rates were consistently lower in two healthcare regions. There were no differences in the 365-day mortality rate for infants alive at 12h or for infants born at 25weeks. Neonatal morbidity rates among survivors were not higher in regions with better survival rates. Perinatal practices varied between regions. ConclusionMortality rates in extremely preterm infants varied considerably between Swedish healthcare regions in the first year after birth, particularly between the most immature infants.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2014
Keyword
Cohort study; Extremely preterm infant; Morbidity; Mortality; Outcome
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-103276 (URN)10.1111/apa.12421 (DOI)000328736300013 ()
Available from: 2014-01-17 Created: 2014-01-16 Last updated: 2017-12-06
Samuelsson, A., Isaksson, B., Hanberger, H. & Olhager, E. (2014). Late onset neonatal sepsis, risk factors and interventions: an analysis of recurrent outbreaks of Serratia marcescens 2006-2011. Journal of Hospital Infection, 86(1), 57-63
Open this publication in new window or tab >>Late onset neonatal sepsis, risk factors and interventions: an analysis of recurrent outbreaks of Serratia marcescens 2006-2011
2014 (English)In: Journal of Hospital Infection, ISSN 0195-6701, E-ISSN 1532-2939, Vol. 86, no 1, p. 57-63Article in journal (Refereed) Published
Abstract [en]

Background: during the period 2006 to 2011 we observed 11 patients with Serratia marcescens sepsis, a total of 47 patients were colonised due to spread of different clones. These recurrent clusters brought about interventions to reduce spread between patients.

Aim: to evaluate the effect of stepwise introduced interventions to prevent S marcescens colonisation/sepsis and to analyse risk factors for late onset sepsis (LOS).

Methods: to evaluate the interventions an open retrospective observational study was performed. A retrospective case-control study was performed to analyse risk factors for LOS.

Findings: main findings of this study were the decrease in S marcescens sepsis and colonisation after the stepwise adoption of hygiene interventions, as well as identifying low gestational age, low birth weight, indwelling central venous or umbilical catheter and ventilator treatment as risk factors for LOS. Compliance to basic hygiene guidelines was the only intervention continuously monitored from late 2007. Compliance increased gradually to a steady high level early 2009. There was a decrease in LOS with S marcescens (LOS-Ser) clustering after the second quarter of 2008. After the first quarter of 2009 we saw a decrease in S marcescens colonisation.

Conclusion: We were not able to isolate specific effects of each intervention, but an update of our antibiotic policy probably had effect on the occurrence of LOS-ser. The delayed effect of interventions on S marcescens colonisation was probably due to the time it takes for new routines to have impact, illustrated by the gradual increase in compliance to basic hygiene guidelines.

Place, publisher, year, edition, pages
Elsevier, 2014
Keyword
Serratia marcescens, outbreak, neonatal, late onset sepsis
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-97707 (URN)10.1016/j.jhin.2013.09.017 (DOI)000328481500009 ()
Available from: 2013-09-20 Created: 2013-09-20 Last updated: 2017-12-06Bibliographically approved
Olhager, E., Nold-Petry, C. A., Joshi, M. S., Doery, J. C. G., Samarasinghe, T., Walker, A. M. & Wong, F. Y. (2014). Preterm lambs given intravenous dopamine show increased dopamine in their cerebrospinal fluid. Acta Paediatrica, 103(3), 337-342
Open this publication in new window or tab >>Preterm lambs given intravenous dopamine show increased dopamine in their cerebrospinal fluid
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2014 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 103, no 3, p. 337-342Article in journal (Refereed) Published
Abstract [en]

AimDopamine is used as an inotropic medication in preterm infants. The preterm human blood brain barrier (BBB) is permeable to intravascular dopamine, and the impact of exogenous dopamine on the preterm brain remains unknown. The preterm lamb model may be suitable for studying the cerebral impact of dopamine therapy whether its BBB permeability is similar to preterm human infants. We aimed to examine BBB permeability to exogenous dopamine in the preterm lamb, by measuring dopamine levels in the cerebrospinal fluid (CSF). MethodsNine preterm foetal lambs (125-130days, term=147days) were given either dopamine at 10g/kg/min (dopamine, n=4) or saline (control, n=5). CSF, and plasma samples were taken for dopamine assay. ResultsThe median (range) baseline CSF dopamine level for the combined control and dopamine groups (n=9) was 0.10(0.03-0.16)ng/mL, and baseline plasma dopamine was 0.30(0.13-0.84) ng/mL. The dopamine lambs showed increase in CSF dopamine to 3.91(1.87-11.35)ng/mL with plasma dopamine increased to 14.2 (9.1-57.9)ng/mL. No change was found in the control lambs. ConclusionIn the preterm lamb, the BBB permeability and pharmacokinetics to dopamine infusion are similar to findings in the preterm human infant, supporting applicability of the preterm lamb model for studying effects of dopamine infusion in the preterm human brain.

Place, publisher, year, edition, pages
Wiley, 2014
Keyword
Blood brain barrier; Dopamine; Hypotension; Infants; Preterm
National Category
Clinical Medicine
Identifiers
urn:nbn:se:liu:diva-105743 (URN)10.1111/apa.12520 (DOI)000331270000031 ()
Available from: 2014-04-07 Created: 2014-04-04 Last updated: 2017-12-05
Serenius, F., Kallen, K., Blennow, M., Ewald, U., Fellman, V., Holmström, G., . . . Strömberg, B. (2013). Neurodevelopmental Outcome in Extremely Preterm Infants at 2.5 Years After Active Perinatal Care in Sweden. Obstetrical and Gynecological Survey, 68(12), 781-783
Open this publication in new window or tab >>Neurodevelopmental Outcome in Extremely Preterm Infants at 2.5 Years After Active Perinatal Care in Sweden
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2013 (English)In: Obstetrical and Gynecological Survey, ISSN 0029-7828, E-ISSN 1533-9866, Vol. 68, no 12, p. 781-783Article in journal, Editorial material (Other academic) Published
Abstract [en]

 A proactive approach to the care of extremely preterm infants has increased survival and lowered the gestational age of viability, but these improvements may be associated with later neurodevelopmental disability. EXPRESS is a national population-based prospective study of all infants born alive or stillborn at less than 27 weeks’ gestation between 2004 and 2007 in Sweden. This prospective follow-up study was undertaken to assess neurologic and developmental outcome of the EXPRESS cohort at 2.5 years corrected age compared with a matched control group born at term.

Of 707 live-born infants, 497 (70%) survived to corrected age 2.5 years; the final cohort included 491 children. Each preterm child was matched with 2 control subjects at 2.5 years chronological age. Cognitive, language, and motor development were assessed with the Bayley Scales of Infant and Toddler Development (Bayley III). Cerebral palsy (CP), visual and hearing disability, and a composite outcome of overall disabilities were assessed. The overall outcome was characterized as no, mild, moderate, and severe disability.

Of 415 infants assessed with clinical examinations, 399, 393, and 382, respectively, completed the Bayley III cognitive, language, and motor scales; 366 control children were assessed with Bayley III. The mean composite cognitive, language, and motor scores for children in the preterm and control groups were 94 ± 12 and 104 ± 11, respectively (P < 0.001), 98 ± 17 and 109 ± 12 (P < 0.001), respectively, and 94 ± 16 and 107 ± 14 (P < 0.001), respectively. Normal cognitive development or mild cognitive disability was found in 354 preterm children (88.8%) and 364 control children (99.5%). Moderate or severe cognitive disability was present in 20 preterm children (5.0%) and 1 control child (0.3%) (P < 0.001) and in 25 (6.3%) and 1 (0.3%), respectively (P < 0.001). Normal language development or mild language disability was found in 330 children (83.9%) in the preterm group and with 351 (97.5%) in the control group (all group comparisons, P < 0.001). Normal motor development or mild motor disability occurred in 324 (84.8%) and 348 (98.6%) of children in the preterm and control groups, respectively. Moderate or severe mental developmental delay was seen in 88 and 10 children (20% and 2.8%), respectively (P < 0.001).

In the preterm group, Bayley III cognitive, language, and motor scores increased with advancing gestational age at birth by 2.5 points (99% confidence interval [CI], 1.0–4.0) per week (P < 0.001), by 3.6 points (99% CI, 1.6–5.6) per week (P < 0.001), and by 2.5 points (99% CI, 0.5–4.5) per week scores (P = 0.001), respectively. Cerebral palsy was present in 32 preterm children (7.0%; 99% CI, 3.9–10.1%). Of 456 preterm children, 42.1% were classified as normal, 30.7% as having mild disabilities, and 27.2% as having moderate or severe disabilities (vs 78.1%, 18.6%, 3.3% of control subjects, respectively; P < 0.001 for all comparisons). The proportion of children with mild or no disabilities increased from 40% at 22 weeks to 83% at 26 weeks (P < 0.001 for trend). Moderate or severe disabilities decreased from 60% at 22 weeks to 17% at 26 weeks (P < 0.001 for trend).

The impact of prematurity on neurodevelopmental outcome indicates that further improvements in neonatal care are necessary. Although preterm children had poorer neurodevelopmental outcomes than those born at term, 73% had no or mild disability, and neurodevelopmental outcome improved with each week of gestational age. These results are relevant for clinicians counseling couples facing extremely preterm birth of their infant

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2013
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-104845 (URN)10.1097/OGX.0000000000000019 (DOI)000330517100002 ()
Available from: 2014-02-28 Created: 2014-02-28 Last updated: 2017-12-05Bibliographically approved
Serenius, F., Källén, K., Blennow, M., Ewald, U., Fellman, V., Holmström, G., . . . Strömberg, B. (2013). Neurodevelopmental Outcome in Extremely Preterm Infants at 2.5 Years After Active Perinatal Care in Sweden. Journal of the American Medical Association (JAMA), 309(17), 1810-1820
Open this publication in new window or tab >>Neurodevelopmental Outcome in Extremely Preterm Infants at 2.5 Years After Active Perinatal Care in Sweden
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2013 (English)In: Journal of the American Medical Association (JAMA), ISSN 0098-7484, E-ISSN 1538-3598, Vol. 309, no 17, p. 1810-1820Article in journal (Refereed) Published
Abstract [en]

IMPORTANCE:

Active perinatal care increases survival of extremely preterm infants; however, improved survival might be associated with increased disability among survivors.

OBJECTIVE:

To determine neurodevelopmental outcome in extremely preterm children at 2.5 years (corrected age).

DESIGN, SETTING, AND PARTICIPANTS:

Population-based prospective cohort of consecutive extremely preterm infants born before 27 weeks of gestation in Sweden between 2004 and 2007. Of 707 live-born infants, 491 (69%) survived to 2.5 years. Survivors were assessed and compared with singleton control infants who were born at term and matched by sex, ethnicity, and municipality. Assessments ended in February 2010 and comparison estimates were adjusted for demographic differences.

MAIN OUTCOMES AND MEASURES:

Cognitive, language, and motor development was assessed with Bayley Scales of Infant and Toddler Development (3rd edition; Bayley-lll), which are standardized to mean (SD) scores of 100 (15). Clinical examination and parental questionnaires were used for diagnosis of cerebral palsy and visual and hearing impairments. Assessments were made by week of gestational age.

RESULTS:

At a median age of 30.5 months (corrected), 456 of 491 (94%) extremely preterm children were evaluated (41 by chart review only). For controls, 701 had information on health status and 366 had Bayley-lll assessments. Mean (SD) composite Bayley-III scores (cognition, 94 [12.3]; language, 98 [16.5]; motor, 94 [15.9]) were lower than the corresponding mean scores for controls (cognition, 104 [10.6]; P < .001; adjusted difference in mean scores, 9.2 [99% CI, 6.9-11.5]; language, 109 [12.3]; P < .001; adjusted difference in mean scores, 9.3 [99% Cl, 6.4-12.3]; and motor, 107 [13.7]; P < .001; adjusted difference in mean scores, 12.6 [99% Cl, 9.5-15.6]). Cognitive disability was moderate in 5% of the extremely preterm group vs 0.3% in controls (P < .001) and it was severe in 6.3% of the extremely preterm group vs 0.3% in controls (P < .001). Language disability was moderate in 9.4% of the extremely preterm group vs 2.5% in controls (P < .001) and severe in 6.6% of the extremely preterm group vs 0% in controls (P < .001). Other comparisons between the extremely preterm group vs controls were for cerebral palsy (7.0% vs 0.1%; P < .001), for blindness (0.9% vs 0%; P = .02), and for hearing impairment (moderate and severe, 0.9% vs 0%; P = .02, respectively). Overall, 42% (99% CI, 36%-48%) of extremely preterm children had no disability, 31% (99% CI, 25%-36%) had mild disability, 16% (99% CI, 12%-21%) had moderate disability, and 11% (99% CI, 7.2%-15%) had severe disability. Moderate or severe overall disability decreased with gestational age at birth (22 weeks, 60%; 23 weeks, 51%; 24 weeks, 34%; 25 weeks, 27%; and 26 weeks, 17%; P for trend < .001).

CONCLUSIONS AND RELEVANCE:

Of children born extremely preterm and receiving active perinatal care, 73% had mild or no disability and neurodevelopmental outcome improved with each week of gestational age. These results are relevant for clinicians counseling families facing extremely preterm birth.

Place, publisher, year, edition, pages
American Medical Association, 2013
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-96148 (URN)10.1001/jama.2013.3786 (DOI)000318235600029 ()23632725 (PubMedID)
Available from: 2013-08-14 Created: 2013-08-14 Last updated: 2017-12-06Bibliographically approved
Stoltz Sjostrom, E., Ohlund, I., Ahlsson, F., Engstrom, E., Fellman, V., Hellstrom, A., . . . Domellof, M. (2013). Nutrient intakes independently affect growth in extremely preterm infants: results from a population-based study. Acta Paediatrica, 102(11), 1067-1074
Open this publication in new window or tab >>Nutrient intakes independently affect growth in extremely preterm infants: results from a population-based study
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2013 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 102, no 11, p. 1067-1074Article in journal (Refereed) Published
Abstract [en]

AimTo explore associations between energy and macronutrient intakes and early growth in extremely low gestational age (ELGA) infants. less thanbrgreater than less thanbrgreater thanMethodsRetrospective population-based study of all ELGA infants (andlt;27weeks) born in Sweden during 2004-2007. Detailed data on nutrition and anthropometric measurements from birth to 70days of postnatal age were retrieved from hospital records. less thanbrgreater than less thanbrgreater thanResultsStudy infants (n=531) had a meanSD gestational age of 25.3 +/- 1.1weeks and a birth weight of 765 +/- 170g. Between 0 and 70days, average daily energy and protein intakes were 120 +/- 11kcal/kg and 3.2 +/- 0.4g/kg, respectively. During this period, standard deviation scores for weight, length and head circumference decreased by 1.4, 2.3 and 0.7, respectively. Taking gestational age, baseline anthropometrics and severity of illness into account, lower energy intake correlated with lower gain in weight (r=+0.315, pandlt;0.001), length (r=+0.215, pandlt;0.001) and head circumference (r=+0.218, pandlt;0.001). Protein intake predicted growth in all anthropometric outcomes, and fat intake was positively associated with head circumference growth. less thanbrgreater than less thanbrgreater thanConclusionExtremely low gestational age infants received considerably less energy and protein than recommended and showed postnatal growth failure. Nutrient intakes were independent predictors of growth even after adjusting for severity of illness. These findings suggest that optimized energy and macronutrient intakes may prevent early growth failure in these infants.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2013
Keyword
Energy intake, Extremely preterm infants, Growth failure, Nutrient intake, Protein
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-100302 (URN)10.1111/apa.12359 (DOI)000325265500021 ()
Note

Funding Agencies|May Flower Charity Foundation||Lilla Barnets Fond||Queen Silvias Jubilee Foundation||Oskar Foundation||Swedish Nutrition Foundation (SNF)||Stockholm County Council||Karolinska Institutet (ALF)||Umea University||Vasterbotten County Council||

Available from: 2013-11-04 Created: 2013-11-04 Last updated: 2017-12-06
Mernelius, S., Lofgren, S., Lindgren, P.-E., Blomberg, M., Olhager, E., Gunnervik, C., . . . Matussek, A. (2013). The effect of improved compliance with hygiene guidelines on transmission of Staphylococcus aureus to newborn infants: The Swedish Hygiene Intervention and Transmission of S aureus study. American Journal of Infection Control, 41(7), 585-590
Open this publication in new window or tab >>The effect of improved compliance with hygiene guidelines on transmission of Staphylococcus aureus to newborn infants: The Swedish Hygiene Intervention and Transmission of S aureus study
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2013 (English)In: American Journal of Infection Control, ISSN 0196-6553, E-ISSN 1527-3296, Vol. 41, no 7, p. 585-590Article in journal (Refereed) Published
Abstract [en]

Background: Newborn infants are often colonized with Staphylococcus aureus originating from health care workers (HCWs). We therefore use colonization with S aureus of newborn infants to determine the effect of an improved compliance with hygiene guidelines on bacterial transmission. Methods: Compliance with hygiene guidelines was monitored prior to (baseline) and after (follow-up) a multimodal hygiene intervention in 4 departments of obstetrics and gynecology. spa typing was used to elucidate transmission routes of S aureus collected from newborn infants, mothers, fathers, staff members, and environment. Results: The compliance with hygiene guidelines increased significantly from baseline to follow-up. The transmission of S aureus from HCWs to infants was however not affected. Fathers had the highest colonization rates. Persistent carriage was indicated in 18% of the HCWs. The most commonly isolated spa type was t084, which was not detected in a previous study from the same geographic area. Conclusion: It is possible to substantially improve the compliance with hygiene guidelines, by using multimodal hygiene intervention. The improved compliance did not decrease the transmission of S aureus from sources outside the own family to newborn infants. Furthermore, we show the establishment of a new spa type (t084), which now is very common in our region. Copyright (C) 2013 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Place, publisher, year, edition, pages
Elsevier, 2013
Keyword
Compliance rates; The Swedish HITS-study; spa typing; Persistent carriage; Colonization; Carriage; Multimodal hygiene intervention
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-96178 (URN)10.1016/j.ajic.2012.09.014 (DOI)000321046300004 ()
Available from: 2013-08-14 Created: 2013-08-14 Last updated: 2017-12-06
Mörelius, E., Angelhoff, C., Eriksson, J. & Olhager, E. (2012). Time of initiation of skin-to-skin contact in extremely preterm infants in Sweden. Acta Paediatrica, 101(1), 14-18
Open this publication in new window or tab >>Time of initiation of skin-to-skin contact in extremely preterm infants in Sweden
2012 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 101, no 1, p. 14-18Article in journal (Refereed) Published
Abstract [en]

Aim:  To describe the time of first skin-to-skin contact in extremely preterm infants in a national perspective and to investigate possible factors affecting the time of first skin-to-skin contact. Methods:  A population-based prospective descriptive study of extremely preterm infants (n = 520) in seven regional hospitals in Sweden. Results:  Extremely preterm infants in Sweden experience first skin-to-skin contact with the parent at a median of six postnatal days (range 0-44). Low gestational age, a high score on the clinical risk index for babies, and the number of days on a ventilator tended to delay first skin-to-skin contact. A statistically significant difference was also found between regional hospitals. Conclusion:  There is a difference in the time of first skin-to-skin contact based on the infant's medical condition and the tradition in the neonatal intensive care unit at the regional hospital where the infant is born.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2012
Keyword
kangaroo mother care, skin-to-skin contact, extremely low birth weight
National Category
Nursing Pediatrics
Identifiers
urn:nbn:se:liu:diva-71441 (URN)10.1111/j.1651-2227.2011.02398.x (DOI)000297630000014 ()
Available from: 2011-10-18 Created: 2011-10-18 Last updated: 2017-12-08
Austeng, D., Blennow, M., Ewald, U., Fellman, V., Fritz, T., Hellstrom-Westas, L., . . . Westgren, M. (2010). Incidence of and risk factors for neonatal morbidity after active perinatal care: extremely preterm infants study in Sweden (EXPRESS). ACTA PAEDIATRICA, 99(7), 978-992
Open this publication in new window or tab >>Incidence of and risk factors for neonatal morbidity after active perinatal care: extremely preterm infants study in Sweden (EXPRESS)
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2010 (English)In: ACTA PAEDIATRICA, ISSN 0803-5253, Vol. 99, no 7, p. 978-992Article in journal (Refereed) Published
Abstract [en]

Aims: The aim of this study was to determine the incidence of neonatal morbidity in extremely preterm infants and to identify associated risk factors. Methods: Population based study of infants born before 27 gestational weeks and admitted for neonatal intensive care in Sweden during 2004-2007. Results: Of 638 admitted infants, 141 died. Among these, life support was withdrawn in 55 infants because of anticipation of poor long-term outcome. Of 497 surviving infants, 10% developed severe intraventricular haemorrhage (IVH), 5.7% cystic periventricular leucomalacia (cPVL), 41% septicaemia and 5.8% necrotizing enterocolitis (NEC); 61% had patent ductus arteriosus (PDA) and 34% developed retinopathy of prematurity (ROP) stage andgt;= 3. Eighty-five per cent needed mechanical ventilation and 25% developed severe bronchopulmonary dysplasia (BPD). Forty-seven per cent survived to one year of age without any severe IVH, cPVL, severe ROP, severe BPD or NEC. Tocolysis increased and prolonged mechanical ventilation decreased the chances of survival without these morbidities. Maternal smoking and higher gestational duration were associated with lower risk of severe ROP, whereas PDA and poor growth increased this risk. Conclusion: Half of the infants surviving extremely preterm birth suffered from severe neonatal morbidities. Studies on how to reduce these morbidities and on the long-term health of survivors are warranted.

Place, publisher, year, edition, pages
Blackwell Publishing Ltd, 2010
Keyword
Bronchopulmonary dysplasia, Intraventricular haemorrhage, Necrotizing enterocolitis, Patent ductus arteriosus, Retinopathy of prematurity
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-57421 (URN)10.1111/j.1651-2227.2010.01846.x (DOI)000278294800008 ()
Available from: 2010-06-18 Created: 2010-06-18 Last updated: 2010-06-18
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