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Cited by 572

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Preterm neonatal morbidity and mortality by gestational age: a contemporary cohort

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Manuck, Tracy A., Rice, Madeline Murguia, Bailit, Jennifer L., Grobman, William A., Reddy, Uma M., Wapner, Ronald J., Thorp, John M., Caritis, Steve N., Prasad, Mona, Tita, Alan T.N., Saade, George R., Sorokin, Yoram, Rouse, Dwight J., Blackwell, Sean C., Tolosa, Jorge E., Varner, M., Hill, K., Sowles, A., Postma, J., Alexander, S., Andersen, G., Scott, V., Morby, V., Jolley, K., Miller, J., Berg, B., Talucci, M., Zylfijaj, M., Reid, Z., Leed, R., Benson, J., Forester, S., Kitto, C., Davis, S., Falk, M., Perez, C., Dorman, K., Mitchell, J., Kaluta, E., Clark, K., Spicer, K., Timlin, S., Wilson, K., Leveno, K., Moseley, L., Santillan, M., Price, J., Buentipo, K., Bludau, V., Thomas, T., Fay, L., Melton, C., Kingsbery, J., Benezue, R., Simhan, H., Bickus, M., Fischer, D., Kamon, T., DeAngelis, D., Mercer, B., Milluzzi, C., Dalton, W., Dotson, T., McDonald, P., Brezine, C., McGrail, A., Latimer, C., Guzzo, L., Johnson, F., Gerwig, L., Fyffe, S., Loux, D., Frantz, S., Cline, D., Wylie, S., Iams, J., Wallace, M., Northen, A., Grant, J., Colquitt, C., Rouse, D., Andrews, W., Mallett, G., Ramos-Brinson, M., Roy, A., Stein, L., Campbell, P., Collins, C., Jackson, N., Dinsmoor, M., Senka, J., Paychek, K., Peaceman, A., Moss, J., Salazar, A., Acosta, A., Hankins, G., Hauff, N., Palmer, L., Lockhart, P., Driscoll, D., Wynn, L., Sudz, C., Dengate, D., Girard, C., Field, S., Breault, P., Smith, F., Annunziata, N., Allard, D., Silva, J., Gamage, M., Hunt, J., Tillinghast, J., Corcoran, N., Jimenez, M., Ortiz, F., Givens, P., Rech, B., Moran, C., Hutchinson, M., Spears, Z., Carreno, C., Heaps, B., Zamora, G., Seguin, J., Rincon, M., Snyder, J., Farrar, C., Lairson, E., Bonino, C., Smith, W., Beach, K., Van Dyke, S., Butcher, S., Thom, E., Zhao, Y., McGee, P., Momirova, V., Palugod, R., Reamer, B., Larsen, M., Williams, T., Spangler, T., Lozitska, A., Spong, C., Tolivaisa, S., VanDorsten, J.P.·2016·American Journal of Obstetrics and Gynecology
DOI 10.1016/j.ajog.2016.01.004
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Abstract

Background Although preterm birth less than 37 weeks gestation is the leading cause of neonatal morbidity and mortality in the United States, the majority of data regarding preterm neonatal outcomes come from older studies, and many reports have been limited to only very preterm neonates. Delineation of neonatal outcomes by delivery gestational age is needed to further clarify the continuum of mortality and morbidity frequencies among preterm neonates. Objective We sought to describe the contemporary frequencies of neonatal death, neonatal morbidities, and neonatal length of stay across the spectrum of preterm gestational ages. Study Design Secondary analysis of an obstetric cohort of 115,502 women and their neonates who were born in 25 hospitals nationwide, 2008–2011. All live born non-anomalous singleton preterm (23.0–36.9 weeks of gestation) neonates were included in this analysis. The frequency of neonatal death, major neonatal morbidity (intraventricular hemorrhage grade III/IV, seizures, hypoxic-ischemic encephalopathy, necrotizing enterocolitis stage II/III, bronchopulmonary dysplasia, persistent pulmonary hypertension), and minor neonatal morbidity (hypotension requiring treatment, intraventricular hemorrhage grade 1/2, necrotizing enterocolitis stage 1, respiratory distress syndrome, hyperbilirubinemia requiring treatment) were calculated by delivery gestational age; each neonate was classified once by the worst outcome they met criteria for. Results 8,334 deliveries met inclusion criteria. There were 119 neonatal deaths (1.4%). 657 (7.9%) neonates had major morbidity, 3,136 (37.6%) had minor morbidity, and 4,422 (53.1%) survived without any of the studied morbidities. Deaths declined rapidly with each advancing week of gestation. This decline in death was accompanied by an increase in major neonatal morbidity, which peaked at 54.8% at 25 weeks of gestation. As frequencies of death, and major neonatal morbidity fell, minor neonatal morbidity increased, peaking at 81.7% at 31 weeks of gestation. The frequency of all morbidities fell beyond 32 weeks. Neonatal length of hospital stay decreased significantly with each additional completed week of pregnancy; among babies delivered from 26 to 32 weeks of gestation, each additional week in utero reduced the subsequent length of neonatal hospitalization by a minimum of 8 days. The median post-menstrual age at discharge nadired at 35.7 weeks post-menstrual age for babies born at 32–33 weeks of gestation. Conclusions Our data show that there is a continuum of outcomes, with each additional week for gestation conferring survival benefit while reducing the length of initial hospitalization. These contemporary data can be useful for patient counseling regarding preterm outcomes.

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Research works printed but not linked: 26

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Metadata

Authors
Manuck, T. A., Rice, M. M., Bailit, J. L., Grobman, W. A., Reddy, U. M., Wapner, R. J., Thorp, J. M., Caritis, S. N., Prasad, M., Tita, A. T. N., Saade, G. R., Sorokin, Y., Rouse, D. J., Blackwell, S. C., Tolosa, J. E., Varner, M., Hill, K., Sowles, A., Postma, J., Alexander, S., Andersen, G., Scott, V., Morby, V., Jolley, K., Miller, J., Berg, B., Talucci, M., Zylfijaj, M., Reid, Z., Leed, R., Benson, J., Forester, S., Kitto, C., Davis, S., Falk, M., Perez, C., Dorman, K., Mitchell, J., Kaluta, E., Clark, K., Spicer, K., Timlin, S., Wilson, K., Leveno, K., Moseley, L., Santillan, M., Price, J., Buentipo, K., Bludau, V., Thomas, T., Fay, L., Melton, C., Kingsbery, J., Benezue, R., Simhan, H., Bickus, M., Fischer, D., Kamon, T., DeAngelis, D., Mercer, B., Milluzzi, C., Dalton, W., Dotson, T., McDonald, P., Brezine, C., McGrail, A., Latimer, C., Guzzo, L., Johnson, F., Gerwig, L., Fyffe, S., Loux, D., Frantz, S., Cline, D., Wylie, S., Iams, J., Wallace, M., Northen, A., Grant, J., Colquitt, C., Rouse, D., Andrews, W., Mallett, G., Ramos-Brinson, M., Roy, A., Stein, L., Campbell, P., Collins, C., Jackson, N., Dinsmoor, M., Senka, J., Paychek, K., Peaceman, A., Moss, J., Salazar, A., Acosta, A., Hankins, G., Hauff, N., Palmer, L., Lockhart, P., Driscoll, D., Wynn, L., Sudz, C., Dengate, D., Girard, C., Field, S., Breault, P., Smith, F., Annunziata, N., Allard, D., Silva, J., Gamage, M., Hunt, J., Tillinghast, J., Corcoran, N., Jimenez, M., Ortiz, F., Givens, P., Rech, B., Moran, C., Hutchinson, M., Spears, Z., Carreno, C., Heaps, B., Zamora, G., Seguin, J., Rincon, M., Snyder, J., Farrar, C., Lairson, E., Bonino, C., Smith, W., Beach, K., Van Dyke, S., Butcher, S., Thom, E., Zhao, Y., McGee, P., Momirova, V., Palugod, R., Reamer, B., Larsen, M., Williams, T., Spangler, T., Lozitska, A., Spong, C., Tolivaisa, S., & VanDorsten, J. P.
Venue
American Journal of Obstetrics and Gynecology
Publisher
Elsevier BV
Published
2016-07
Volume
215
Issue
1
Pages
103.e1-103.e14
ISSN
0002-9378 (ISSN-L)
DOI
10.1016/j.ajog.2016.01.004
OpenAlex
W2223012991
Cited by
572
References
3
FWCI
38.34
Type
journal article
Language
en
Open access
green
Licence
  • www.elsevier.com/tdm/userlicense/1.0/ (tdm)
  • www.elsevier.com/legal/tdmrep-license (tdm)
Funders
  • National Center for Research Resources (5UL1 RR025764, UL1 RR024989, 5K23HD067224)
  • Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD21410, HD27869, HD34208, HD40544, HD53097, HD27917, HD40485, HD27915, HD40500, HD40545, HD53118, HD40560, HD34116, HD36801, HD40512)

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CoChat. (2026). Citation check: Preterm neonatal morbidity and mortality by gestational age: a contemporary cohort. https://app.cochat.ai/papers/10.1016/j.ajog.2016.01.004
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Manuck, T. A., Rice, M. M., Bailit, J. L., Grobman, W. A., Reddy, U. M., Wapner, R. J., Thorp, J. M., Caritis, S. N., Prasad, M., Tita, A. T. N., Saade, G. R., Sorokin, Y., Rouse, D. J., Blackwell, S. C., Tolosa, J. E., Varner, M., Hill, K., Sowles, A., Postma, J., . . . VanDorsten, J. P. (2016). Preterm neonatal morbidity and mortality by gestational age: a contemporary cohort. American Journal of Obstetrics and Gynecology. https://doi.org/10.1016/j.ajog.2016.01.004

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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