Mortality and length of stay of very low birth weight and very preterm infants: a EuroHOPE study

The objective of this paper was to compare health outcomes and hospital care use of very low birth weight (VLBW), and very preterm (VLGA) infants in seven European countries. Analysis was performed on linkable patient-level registry data from seven European countries between 2006 and 2008 (Finland, Hungary, Italy (the Province of Rome), the Netherlands, Norway, Scotland, and Sweden). Mortality and length of stay (LoS) were adjusted for differences in gestational age (GA), sex, intrauterine growth, Apgar score at five minutes, parity and multiple births. The analysis included 16,087 infants. Both the 30-day and one-year adjusted mortality rates were lowest in the Nordic countries (Finland, Sweden and Norway) and Scotland and highest in Hungary and the Netherlands. For survivors, the adjusted average LoS during the first year of life ranged from 56 days in the Netherlands and Scotland to 81 days in Hungary. There were large differences between European countries in mortality rates and LoS in VLBW and VLGA infants. Substantial data linkage problems were observed in most countries due to inadequate identification procedures at birth, which limit data validity and should be addressed by policy makers across Europe

Risk adjusted average number of hospital days during FHE.^a

<p>A confidence interval: 95%.</p><p>^a The first hospital episode (FHE) starts at the day of birth and includes all continuous hospital days, including transfers between different hospitals.</p><p>Risk adjusted average number of hospital days during FHE.<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0131685#t005fn002" target="_blank">^a</a></p

Unadjusted mortality rates (%) within 30 days: by gestational age.

<p>^a For the >32 weeks category, figs for the Netherlands were too small to be reported for two of the gestational age groupings.</p><p>^b Only linkable infants included.</p><p>Unadjusted mortality rates (%) within 30 days: by gestational age.</p

Risk adjusted average number of hospital days during the first year of life.^a

<p>A confidence interval: 95%.</p><p>^a Figs include all hospital days, not necessarily continuous.</p><p>Risk adjusted average number of hospital days during the first year of life.<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0131685#t006fn002" target="_blank">^a</a></p

Risk adjusted mortality rates at 30 days and at 1 year.

<p>^aAdjusted for gestational age (GA), sex, intrauterine growth (small for gestational age), Apgar score at five minutes, parity and multiple births. A confidence interval: 95%.</p

Number and proportion of VLBW and VLGA infants among live-born infants in EuroHOPE data.

<p>^aThe Netherlands: 2006–2007, Norway: 2008–2009</p><p>^bThe European Perinatal Health Report 2008 is based on data from 2004, incidence figs are per 100 live-born infants</p><p>^cThe linkage is between MBR and Cause of Death Registry. The linkage with the HDR for LoS analysis was 65%</p><p>^dThe linkage is between MBR and Cause of Death Registry. The linkage with the HDR for LoS analysis was 58%</p><p>Number and proportion of VLBW and VLGA infants among live-born infants in EuroHOPE data.</p

Unadjusted mortality rates (%) within 365 days: by gestational age.

<p>^a For the >32 weeks category, figs for the Netherlands were too small to be reported for two of the gestational age groupings.</p><p>^b Only linkable infants included.</p><p>Unadjusted mortality rates (%) within 365 days: by gestational age.</p