Dataset Information

Mortality and morbidity of VLBW infants with trisomy 13 or trisomy 18.

ABSTRACT: OBJECTIVE:Little is known about how very low birth weight (VLBW) affects survival and morbidities among infants with trisomy 13 (T13) or trisomy 18 (T18). We examined the care plans for VLBW infants with T13 or T18 and compared their risks of mortality and neonatal morbidities with VLBW infants with trisomy 21 and VLBW infants without birth defects. METHODS:Infants with birth weight 401 to 1500 g born or cared for at a participating center of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network during the period 1994-2009 were studied. Poisson regression models were used to examine risk of death and neonatal morbidities among infants with T13 or T18. RESULTS:Of 52,262 VLBW infants, 38 (0.07%) had T13 and 128 (0.24%) had T18. Intensity of care in the delivery room varied depending on whether the trisomy was diagnosed before or after birth. The plan for subsequent care for the majority of the infants was to withdraw care or to provide comfort care. Eleven percent of infants with T13 and 9% of infants with T18 survived to hospital discharge. Survivors with T13 or T18 had significantly increased risk of patent ductus arteriosus and respiratory distress syndrome compared with infants without birth defects. No infant with T13 or T18 developed necrotizing enterocolitis. CONCLUSIONS:In this cohort of liveborn VLBW infants with T13 or T18, the timing of trisomy diagnosis affected the plan for care, survival was poor, and death usually occurred early.

SUBMITTER: Boghossian NS

PROVIDER: S-EPMC3904274 | biostudies-literature | 2014 Feb

REPOSITORIES: biostudies-literature

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Mortality and morbidity of VLBW infants with trisomy 13 or trisomy 18.

Boghossian Nansi S NS Hansen Nellie I NI Bell Edward F EF Stoll Barbara J BJ Murray Jeffrey C JC Carey John C JC Adams-Chapman Ira I Shankaran Seetha S Walsh Michele C MC Laptook Abbot R AR Faix Roger G RG Newman Nancy S NS Hale Ellen C EC Das Abhik A Wilson Leslie D LD Hensman Angelita M AM Grisby Cathy C Collins Monica V MV Vasil Diana M DM Finkle Joanne J Maffett Deanna D Ball M Bethany MB Lacy Conra B CB Bara Rebecca R Higgins Rosemary D RD

Pediatrics 20140120 2

<h4>Objective</h4>Little is known about how very low birth weight (VLBW) affects survival and morbidities among infants with trisomy 13 (T13) or trisomy 18 (T18). We examined the care plans for VLBW infants with T13 or T18 and compared their risks of mortality and neonatal morbidities with VLBW infants with trisomy 21 and VLBW infants without birth defects.<h4>Methods</h4>Infants with birth weight 401 to 1500 g born or cared for at a participating center of the Eunice Kennedy Shriver National In ...[more]

PMID: 24446439

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Project description:BACKGROUND:Glutamine is a conditionally essential amino acid. Endogenous biosynthesis may be insufficient for tissue needs in states of metabolic stress. Evidence exists that glutamine supplementation improves clinical outcomes in critically ill adults. It has been suggested that glutamine supplementation may also benefit preterm infants. OBJECTIVES:To determine the effects of glutamine supplementation on mortality and morbidity in preterm infants. SEARCH METHODS:We used the standard search strategy of the Cochrane Neonatal Review Group. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL, 2015, Issue 12), MEDLINE, EMBASE and Maternity and Infant Care (to December 2015), conference proceedings and previous reviews. SELECTION CRITERIA:Randomised or quasi-randomised controlled trials that compared glutamine supplementation versus no glutamine supplementation in preterm infants at any time from birth to discharge from hospital. DATA COLLECTION AND ANALYSIS:We extracted data using the standard methods of the Cochrane Neonatal Review Group, with separate evaluation of trial quality and data extraction by two review authors. We synthesised data using a fixed-effect model and reported typical relative risk, typical risk difference and weighted mean difference. MAIN RESULTS:We identified 12 randomised controlled trials in which a total of 2877 preterm infants participated. Six trials assessed enteral glutamine supplementation and six trials assessed parenteral glutamine supplementation. The trials were generally of good methodological quality. Meta-analysis did not find an effect of glutamine supplementation on mortality (typical relative risk 0.97, 95% confidence interval 0.80 to 1.17; risk difference 0.00, 95% confidence interval -0.03 to 0.02) or major neonatal morbidities including the incidence of invasive infection or necrotising enterocolitis. Three trials that assessed neurodevelopmental outcomes in children aged 18 to 24 months and beyond did not find any effects. AUTHORS' CONCLUSIONS:The available trial data do not provide evidence that glutamine supplementation confers important benefits for preterm infants.

Dataset Information

Mortality and morbidity of VLBW infants with trisomy 13 or trisomy 18.

Publications

Mortality and morbidity of VLBW infants with trisomy 13 or trisomy 18.

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