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@article{Santhakumaran:2017:10.1136/archdischild-2017-312748,
author = {Santhakumaran, S and Gray, D and Statnikov, Y and Battersby, C and Ashby, D and Modi, N},
doi = {10.1136/archdischild-2017-312748},
journal = {Archives of Disease in Childhood-Fetal and Neonatal Edition},
pages = {F208--F215},
title = {Survival of very preterm infants admitted to neonatal care in England 2008-2014: time trends and regional variation},
url = {http://dx.doi.org/10.1136/archdischild-2017-312748},
volume = {103},
year = {2017}
}

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TY  - JOUR
AB  - ObjectiveTo analyse survival trends and regional variation for very preterm infants admitted to neonatal care.SettingAll neonatal units in EnglandPatientsInfants born at 22+0-31+6 weeks+days gestational age (GA) over 2008-2014 and admitted to neonatal care; published data for admitted infants 22+0-25+6 weeks+days GA in 1995 and 2006, and for live births at 22+0-31+6 weeks+days GA in 2013.MethodsWe obtained data from the National Neonatal Research Database (NNRD). We used logistic regression to model survival probability with birth-weight, GA, sex, antenatal steroid exposure, and multiple birth included in the risk-adjustment model, and calculated Average Percentage Change (APC) for trends using joinpoint regression. We evaluated survival over a 20-year period for infants <26 weeks GA using additional published data from the EPICure studies.ResultsWe identified 50,112 eligible infants. There was an increase in survival over 2008-2014 (2008 88.0%, 2014 91.3%; adjusted APC 0.46% (95% Confidence Interval 0.30 to 0.62) p<0.001). The greatest improvement was at 22+0-23+6 weeks (APC 6.03% (2.47 to 3.53) p=0.002). Improvement largely occurred in London and South of England (APC: London 1.26% (0.60 to 1.96); South of England 1.09% (0.36 to 1.82); Midlands and East of England 0.15%(-0.56 to 0.86); North of England 0.26% (-0.54 to 1.07)). Survival at the earliest gestations improved at a similar rate over 1995-2014 (22+0-25+6 weeks, APC 2.73% (2.35 to 3.12) p-value for change=0.25). ConclusionsContinued national improvement in the survival of very preterm admissions masks important regional variation. Timely assessment of preterm survival is feasible using electronic records.
AU  - Santhakumaran,S
AU  - Gray,D
AU  - Statnikov,Y
AU  - Battersby,C
AU  - Ashby,D
AU  - Modi,N
DO  - 10.1136/archdischild-2017-312748
EP  - 215
PY  - 2017///
SN  - 1468-2052
SP  - 208
TI  - Survival of very preterm infants admitted to neonatal care in England 2008-2014: time trends and regional variation
T2  - Archives of Disease in Childhood-Fetal and Neonatal Edition
UR  - http://dx.doi.org/10.1136/archdischild-2017-312748
UR  - http://hdl.handle.net/10044/1/49122
VL  - 103
ER  -

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