Preterm birth in the Nordic countries—Capacity, management and outcome in neonatal care

Mikael Norman*, Jesper Padkær Petersen, Hans Jørgen Stensvold, Thordur Thorkelsson, Kjell Helenius, Charlotte Brix Andersson, Heidi Ørum Cueto, Magnus Domellöf, Mika Gissler, Anna Heino, Stellan Håkansson, Baldvin Jonsson, Claus Klingenberg, Liisa Lehtonen, Marjo Metsäranta, Arild E. Rønnestad, Simon Trautner

*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

Abstract

Aim: Organisation of care, perinatal and neonatal management of very preterm infants in the Nordic regions were hypothesised to vary significantly. The aim of this observational study was to test this hypothesis. Methods: Information on preterm infants in the 21 greater healthcare regions of Denmark, Finland, Iceland, Norway and Sweden was gathered from national registers in 2021. Preterm birth rates, case-mix, perinatal interventions, neonatal morbidity and survival to hospital discharge in very (<32 weeks) and extremely preterm infants (<28 weeks of gestational age) were compared. Results: Out of 287 642 infants born alive, 16 567 (5.8%) were preterm, 2389 (0.83%) very preterm and 800 (0.28%) were extremely preterm. In very preterm infants, exposure to antenatal corticosteroids varied from 85% to 98%, live births occurring at regional centres from 48% to 100%, surfactant treatment from 28% to 69% and use of mechanical ventilation varied from 13% to 77% (p < 0.05 for all comparisons). Significant regional variations within and between countries were also seen in capacity in neonatal care, case-mix and number of admissions, whereas there were no statistically significant differences in survival or major neonatal morbidities. Conclusion: Management of very preterm infants exhibited significant regional variations in the Nordic countries.

Original languageEnglish
JournalActa Paediatrica, International Journal of Paediatrics
Volume112
Issue7
Pages (from-to)1422-1433
Number of pages12
ISSN0803-5253
DOIs
Publication statusPublished - Jul 2023

Keywords

  • gestational age
  • mortality
  • neonatal care
  • Nordic country
  • premature

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