Evaluating preterm care across Europe using the eNewborn European Network database

• Published in: Pediatric research Vol. 88; no. 3; pp. 484 - 495
• Main Authors: Haumont, Dominique, Modi, Neena, Saugstad, Ola D., Antetere, Rosine, NguyenBa, Cuong, Turner, Mark, Costeloe, Kate, Aelvoet, Willem
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01-09-2020; Nature Publishing Group
• Subjects: Apgar score; Medicine; Medicine & Public Health; Mortality; Multiple births; Neonatal care; Pediatric Surgery; Pediatrics; Population Study Article; Premature babies; Premature birth; Quality of care; Europe
• ISSN: 0031-3998; 1530-0447
• DOI: 10.1038/s41390-020-0769-x

Background
The inefficiency of recording data repeatedly limits the number of studies conducted. Here we illustrate the wider use of data captured as part of the European eNewborn benchmarking programme.
Methods
We extracted data on 39,529 live-births from 22 weeks 0 days to 31 weeks 6 days gestational age (GA) or ≤1500 g birth weight. We explored relationships between delivery room care and Apgar scores on mortality and bronchopulmonary dysplasia (BPD) and calculated the time needed for each country to detect a clinically relevant change in these outcomes following a hypothetical intervention.
Results
Early neonatal, neonatal, and in-hospital mortality were 3.90% (95% CI 3.71, 4.09), 6.00% (5.77, 6.24) and 7.57% (7.31, 7.83), respectively. The odds of death were greater with decreasing GA, lower Apgar scores, growth restriction, male sex, multiple birth and no antenatal steroids. Relationships for BPD were similar. The time required for participating countries to achieve 80% power to detect a relevant change in outcomes following a hypothetical intervention in 23–25 weeks’ GA infants ranged from 12 years for neonatal mortality and 22 years for BPD compared to 1 year for the whole network.
Conclusions
The eNewborn platform offers opportunity to drive efficiencies in benchmarking, quality control and research.