Acta Paediatr. 2022 Apr 9. doi: 10.1111/apa.16356. Online ahead of print.
ABSTRACT
AIM: To assess the strength of associations between interrelated perinatal risk factors and mortality in very preterm infants.
METHODS: Information on all liveborn infants delivered in Sweden at 22-31 weeks of gestational age (GA) from 2011 to 2019 was gathered from the Swedish Neonatal Quality Register, excluding infants with major malformations or not resuscitated because of anticipated poor prognosis. Twenty-seven perinatal risk factors available at birth were exposures and in-hospital mortality outcome. Orthogonal partial least squares discriminant analysis was applied to assess proximity between individual risk factors and mortality, and receiver operating characteristics (ROC) curve was used to estimate discriminant ability.
RESULTS: In total, 638/8396 (7.6%) infants died. Thirteen risk factors discriminated reduced mortality, the most important were higher Apgar scores at 5 and 10 minutes, GA and birthweight. Restricting the analysis to preterm infants <28 weeks GA (n=2939, 16.9% mortality) added antenatal corticosteroid therapy as significantly associated with lower mortality. The area under the ROC-curve (the C-statistic) using all risk factors was 0.86, as determined after both internal and external validation.
CONCLUSION: Apgar scores, gestational age and birthweight show stronger associations with mortality in very preterm infants than several other risk perinatal factors available at birth.
PMID:35397189 | DOI:10.1111/apa.16356
