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. 2021 Apr 10;21(1):291.
doi: 10.1186/s12884-021-03726-4.

A birth population-based survey of preterm morbidity and mortality by gestational age

Xiaojing Guo  1 , Xiaoqiong Li  2 , Tingting Qi  2 , Zhaojun Pan  3 , Xiaoqin Zhu  4 , Hui Wang  4 , Ying Dong  1 , Hongni Yue  5   6 , Bo Sun  7
Affiliations

A birth population-based survey of preterm morbidity and mortality by gestational age

Xiaojing Guo et al. BMC Pregnancy Childbirth. .

Erratum in

Abstract

Background: Despite 15-17 millions of annual births in China, there is a paucity of information on prevalence and outcome of preterm birth. We characterized the outcome of preterm births and hospitalized preterm infants by gestational age (GA) in Huai'an in 2015, an emerging prefectural region of China.

Methods: Of 59,245 regional total births, clinical data on 2651 preterm births and 1941 hospitalized preterm neonates were extracted from Huai'an Women and Children's Hospital (HWCH) and non-HWCH hospitals in 2018-2020. Preterm prevalence, morbidity and mortality rates were characterized and compared by hospital categories and GA spectra. Death risks of preterm births and hospitalized preterm infants in the whole region were analyzed with multivariable Poisson regression.

Results: The prevalence of extreme, very, moderate, late and total preterm of the regional total births were 0.14, 0.53, 0.72, 3.08 and 4.47%, with GA-specific neonatal mortality rates being 44.4, 15.8, 3.7, 1.5 and 4.3%, respectively. There were 1025 (52.8% of whole region) preterm admissions in HWCH, with significantly lower in-hospital death rate of inborn (33 of 802, 4.1%) than out-born (23 of 223, 10.3%) infants. Compared to non-HWCH, three-fold more neonates in HWCH were under critical care with higher death rate, including most extremely preterm infants. Significantly all-death risks were found for the total preterm births in birth weight < 1000 g, GA < 32 weeks, amniotic fluid contamination, Apgar-5 min < 7, and birth defects. For the hospitalized preterm infants, significantly in-hospital death risks were found in out-born of HWCH, GA < 32 weeks, birth weight < 1000 g, Apgar-5 min < 7, birth defects, respiratory distress syndrome, necrotizing enterocolitis and ventilation, whereas born in HWCH, antenatal glucocorticoids, cesarean delivery and surfactant use decreased the death risks.

Conclusions: The integrated data revealed the prevalence, GA-specific morbidity and mortality rate of total preterm births and their hospitalization, demonstrating the efficiency of leading referral center and whole regional perinatal-neonatal network in China. The concept and protocol should be validated in further studies for prevention of preterm birth.

Keywords: Birth population; Gestation; Morbidity; Mortality; Preterm; Prevalence; Regional perinatal-neonatal network.

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Conflict of interest statement

All the authors have declared no any financial and non-financial competing interests to disclose.

Figures

Fig. 1
Fig. 1
The flowchart of database and enrolled preterm population by gestational age strata and hospital categories. Abbreviations: EPT, extremely preterm; VPT, very preterm; MPT, moderate preterm; LPT, late preterm; ET, early term. For definitions of deaths and other abbreviations see Table 1 legends
Fig. 2
Fig. 2
The all-death rate, perinatal mortality rate, neonatal mortality rate and in-hospital death rate and corresponding 95% confidence interval by each gestational age. Legends: For definitions of death rates, see Table 1 footnotes
See this image and copyright information in PMC

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