Outcomes for high risk New Zealand newborn infants in 1998–1999: a population based, national study

• Published in: Archives of disease in childhood 2003-01, Vol.88 (1), p.F15-F22
• Main Authors: Cust, A E, Darlow, B A, Donoghue, D A
• Format: Article
• Language: English
• Subjects: Analysis. Health state; ANZNN; Australian and New Zealand Neonatal Network; Biological and medical sciences; Birth weight; Birth weight, Low; Care and treatment; chronic lung disease; CLD; Cohort Studies; continuous positive airways pressure; CPAP; diseases; Epidemiology; Female; Fetal Death - epidemiology; General aspects; gestation; Gestational Age; Health aspects; HMD; Hospitals; Humans; hyaline membrane disease; Infant, Low Birth Weight; Infant, Newborn; Infant, Newborn, Diseases - mortality; Infant, Newborn, Diseases - surgery; Infant, Premature, Diseases - mortality; Infants; Infants (Premature); Intensive Care Units, Neonatal - statistics & numerical data; intermittent positive pressure ventilation; intraventricular haemorrhage; IPPV; IVH; Low birth weight; Male; Medical Audit; Medical sciences; Morbidity; Mortality; NEC; necrotising enterocolitis; Neonatal intensive care; neonatal intensive care unit; New Zealand; New Zealand - epidemiology; Newborn babies; NICU; Original; Patient outcomes; premature; Premature birth; Premature infants; Prognosis; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; Respiration, Artificial; retinopathy of prematurity; Risk Factors; ROP; Treatment Outcome; Tropical medicine; Ventilation; Womens health
• ISSN: 1359-2998; 0003-9888; 1468-2052
• DOI: 10.1136/fn.88.1.F15

Objective: To determine short term morbidity and mortality outcomes, provision of care, and treatments for a national cohort of high risk infants born in 1998–1999 and admitted to New Zealand neonatal intensive care units (NICUs). Setting: All level III (six) and level II (13) NICUs in New Zealand. Methods: Prospective audit by the Australian and New Zealand Neonatal Network (ANZNN) of all infants defined as “high risk” (born at < 32 weeks gestation or < 1500 g birth weight, or received assisted ventilation for four hours or more, or had major surgery). Data were collected from birth until discharge home or death. Results: There were 3368 high risk infants (3.0% of all live births), comprising 1241 (37%) < 32 weeks gestation, 1084 (32%) < 1500 g, 3156 (94%) who received assisted ventilation, and 243 (7%) who received major surgery (categories overlap). Most infants (87%) received some care in tertiary hospitals, and 13% were cared for entirely in non-tertiary hospitals. Survival was 91% for infants < 32 weeks gestation, 97% for infants ≥ 32 weeks gestation who received assisted ventilation, and 92% for infants ≥ 32 weeks gestation who had major surgery. The proportion of very preterm infants who survived free of early major morbidity was 11%, 28%, 53%, 81%, and 90% for infants born at < 24, 24–25, 26–27, 28–29, and 30–31 weeks gestation respectively. Conclusions: These unique population based national data provide contemporary information on the care and early morbidity and mortality outcomes for all high risk infants, whether cared for in hospitals with level III or level II NICUs.