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Preterm birth in the Nordic countries – capacity, management, and outcome in neonatal care

Acta Paediatr. 2023 Mar 13. doi: 10.1111/apa.16753. Online ahead of print.


AIM: Organisation of care, and perinatal and neonatal management of very preterm infants in the Nordic regions were hypothesised to vary significantly. The aim of this observational study was to test this hypothesis.

METHODS: Information on preterm, liveborn infants in the 21 greater health care regions of Denmark, Finland, Iceland, Norway and Sweden was gathered from national registers in 2021. Preterm birth rates, case-mix, perinatal interventions, neonatal morbidity, and survival to hospital discharge in very (<32 weeks) and extremely preterm infants (<28 weeks of gestational age) were compared.

RESULTS: Out of 287,642 infants born alive, 16,567 (5.8%) were preterm, 2389 (0.83%) very preterm (1282 boys), and 800 (0.28%) were extremely preterm. In very preterm infants, exposure to antenatal corticosteroids varied from 85% to 98%, live births occurring at regional centres from 48% to 100%, surfactant treatment from 28% to 69%, and use of mechanical ventilation varied from 13% to 77% (p<0.05 for all comparisons). Significant regional variations within and between countries were also seen in capacity in neonatal care, case-mix, and number of admissions, whereas there were no statistically significant differences in survival or major neonatal morbidities.

CONCLUSION: Management of very preterm infants exhibited significant regional variations in the Nordic countries.

PMID:36912750 | DOI:10.1111/apa.16753

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