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Perinatal outcomes

Duration and Time Trends in Hospital Stay for Very Preterm Infants Differ Across European Regions.
Maier RF, Blondel B, Piedvache A, Misselwitz B, Petrou S, Van Reempts P, Franco F, Barros H, Gadzinowski J, Boerch K, van Heijst A, Draper ES, Zeitlin J; MOSAIC and Effective Perinatal Intensive Care in Europe (EPICE) research groups. 
Pediatr Crit Care Med. 2018 Dec 19(12):1153-1161.

OBJECTIVES: To compare duration and changes over time in length of hospital stay for very preterm and extremely preterm infants in 10 European regions. 

DESIGN: Two area-based cohort studies from the same regions in 2003 and 2011/2012 

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Cohort study from 11 European countries highlighted differences in the use and efficacy of hypothermia prevention strategies after very preterm birth.
Wilson E, Zeitlin J, Piedvache A, Misselwitz B, Christensson K, Maier RF, Norman M, Edstedt Bonamy AK; EPICE Research Group.
Acta Paediatr. (2018)

This study investigated the different strategies used in 11 European countries to prevent hypothermia, which continues to affect a large proportion of preterm births in the region.

We examined the association between the reported use of hypothermia prevention strategies in delivery rooms and body temperatures on admission to neonatal intensive care units (NICUs) in 5861 infants born at 22 + 0 to 31 +6 weeks of gestation. The use of plastic bags, wraps, caps, exothermic heat and mattresses was investigated.

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The Type of Feeding at Discharge of Very Preterm Infants: Neonatal Intensive Care Units Policies and Practices Make a Difference
Rodrigues C, Severo M, Zeitlin J, Barros H, Portuguese EPICE (Effective Perinatal Intensive Care in Europe) Network.
Breastfeed Med. (2017)

The aim was to assess the influence of neonatal intensive care units (NICUs) on feeding practices at discharge of Portuguese very preterm infants.

We analyzed data from 580 very preterm infants (<32 gestational weeks) discharged home from NICUs of two Portuguese regions and enrolled during 2011-2012 in Effective Perinatal Intensive Care in Europe population-based cohort. Maternal and infant characteristics were abstracted from medical records, and heads of NICUs provided the units characteristics. Feeding at discharge was classified as exclusive formula, exclusive breast milk or mixed, and differences among NICUs were obtained by comparison with pooled geometric mean odds of all NICUs, using multinomial logistic regression. Median odds ratios (MOR) were calculated to quantify variability among NICUs using multilevel logistic regression.

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Wide variation in severe neonatal morbidity among very preterm infants in European regions.
Edstedt Bonamy AK, Zeitlin J, Piedvache A, Maier RF, van Heijst A, Varendi H, Manktelow BN, Fenton A, Mazela J, Cuttini M, Norman M, Petrou S, Reempts PV, Barros H, Draper ES; Epice Research Group.
Arch Dis Child Fetal Neonatal Ed. (2018)

The study aim was to investigate the variation in severe neonatal morbidity among very preterm (VPT) infants across European regions and whether morbidity rates are higher in regions with low compared with high mortality rates.

This is an Area-based cohort study of all births before 32 weeks of gestational age. The cohort is composed of 6422 survivors to discharge from neonatal care units from 16 regions in 11 European countries included in 2011/2012.

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Changes in management policies for extremely preterm births and neonatal outcomes from 2003 to 2012: two population-based studies in ten European regions
M Bonet, M Cuttini, A Piedvache, EM Boyle, PH Jarreau, L Kollée, RF Maier, DWA Milligan, P Van Reempts, T Weber, H Barros, J Gadzinowki, ES Draper, J Zeitlin, the MOSAIC and EPICE research groups
BJOG (2017)

Although the survival of infants born extremely preterm (before 27 weeks of gestation) has improved, the survival rates vary greatly across countries. This may reflect different policies for active treatment of these infants. The objective was to study mortality and morbidity in extremely preterm infants in relation to changes in maternity and neonatal unit policies in 10 European regions between 2003 and 2012, using data from the MOSAIC and EPICE cohorts.

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