Neonatal outcomes of preterm infants depending on the care approaches

Introduction. With the improvement in perinatal care management, the survival rate of very and extremely preterm infants increased, while the incidence of neonatal morbidity remained constant. The aim of the study was to analyse and compare two cohorts of Neonatal Intensive Care Unit-admitted preterm infants with gestational age <32 weeks (from Ukraine and Poland), and to identify the key problems of neonatal care, to improve the management of preterm infants. Material and methods. The comparative analysis included survival rates and neonatal outcomes as intraventricular hemorrhage, retinopathy of prematurity, bronchopulmonary dysplasia, late-onset sepsis, necrotizing enterocolitis (NEC), duration of parenteral feeding, breast-feeding rate and infants’ growth parameters. Mann-Whitney U-test and Chi-square test were used for statistical analysis. Results. The survival rate of preterm infants was lower in the cohort from Ukraine compared with Poland (p=0.0076). The late-onset infection rates were higher in extremely and very preterm newborns (p<0.05) and NEC prevailed in very preterm infants (p=0.000) among neonates of Ukraine; the duration of parenteral feeding was significantly higher in both age groups in this cohort. Postnatal growth failure was observed in 57.1% and 29.4% in extremely preterm infants of Ukraine and Poland, respectively (p=0.035). Conclusions. The comparative analysis of short-term outcomes of very and extremely preterm infants in different perinatal centers identified key problems in their management and the possible ways to improve the quality of care. Regular auditing of clinical outcomes and identification of main problems could facilitate quality improvement in preterm infants’ management and help to implement new interventions and approaches.