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Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Article

Population-Based Estimates of In-Unit Survival for Very Preterm Infants

Bradley N. Manktelow, Sarah E. Seaton, David J. Field and Elizabeth S. Draper
Pediatrics February 2013, 131 (2) e425-e432; DOI: https://doi.org/10.1542/peds.2012-2189
Bradley N. Manktelow
Department of Health Sciences, University of Leicester, Leicester, United Kingdom
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Sarah E. Seaton
Department of Health Sciences, University of Leicester, Leicester, United Kingdom
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David J. Field
Department of Health Sciences, University of Leicester, Leicester, United Kingdom
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Elizabeth S. Draper
Department of Health Sciences, University of Leicester, Leicester, United Kingdom
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Abstract

BACKGROUND: Estimates of the probability of survival of very preterm infants admitted to NICU care are vital for counseling parents, informing care, and planning services. In 1999, easy-to-use charts of survival according to gestation, birth weight, and gender were published in the United Kingdom. These charts are widely used in clinical care and for benchmarking survival, and they form the core of the Clinical Risk Index for Babies II score. Since their publication, the survival of preterm infants has improved, and the charts therefore need updating.

METHODS: A logistic model was fitted with gestational age, birth weight, and gender. Nonlinear functions were estimated by using fractional polynomials. Bootstrap methods were used to assess the internal validity of the final model. The final model was assessed both overall and for subgroups of infants by using Farrington’s statistic, the c-statistic, Cox regression coefficients, and the Brier score.

RESULTS: A total of 2995 white singleton infants born at 23+0 to 32+6 weeks’ gestation in 2008 through 2010 were identified; 2751 (91.9%) infants survived to discharge. A prediction model was estimated and good model fit confirmed (area under receiver-operating characteristics curve = 0.86). Survival ranged from 27.7% (23 weeks) to 99.1% (32 weeks) for boys and from 34.5% (23 weeks) to 99.3% (32 weeks) for girls. Updated charts were produced showing estimated survival according to gestation, birth weight and gender, together with contour plots displaying points of equal survival.

CONCLUSIONS: These survival charts have been updated and will be of use to clinicians, parents, and managers.

KEY WORDS
  • mortality
  • neonatal
  • prediction
  • very preterm
  • Abbreviations:
    TNS —
    The Neonatal Survey
    • Accepted October 1, 2012.
    • Copyright © 2013 by the American Academy of Pediatrics

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    Pediatrics
    Vol. 131, Issue 2
    1 Feb 2013
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    Population-Based Estimates of In-Unit Survival for Very Preterm Infants
    Bradley N. Manktelow, Sarah E. Seaton, David J. Field, Elizabeth S. Draper
    Pediatrics Feb 2013, 131 (2) e425-e432; DOI: 10.1542/peds.2012-2189

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    Population-Based Estimates of In-Unit Survival for Very Preterm Infants
    Bradley N. Manktelow, Sarah E. Seaton, David J. Field, Elizabeth S. Draper
    Pediatrics Feb 2013, 131 (2) e425-e432; DOI: 10.1542/peds.2012-2189
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    Subjects

    • Fetus/Newborn Infant
      • Fetus/Newborn Infant

    Keywords

    • mortality
    • neonatal
    • prediction
    • very preterm
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