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Medications and in-hospital outcomes in infants born at 22–24 weeks of gestation

Journal of Perinatology volume 40, pages 781–789 (2020)Cite this article

Subjects

Abstract

Objective

To evaluate the most commonly used medications and in-hospital morbidities and mortality in infants born 22–24 weeks of gestation.

Study design

Multicenter retrospective cohort study of infants born 22–24 weeks of gestation (2006–2016), without major congenital anomalies and with available medication data obtained from neonatal intensive care units managed by the Pediatrix Medical Group.

Results

This study included 7578 infants from 195 sites. Median (25th, 75th percentile): birthweight was 610 g (540, 680); the number of distinct medications used was 13 (8, 18); and different antimicrobial exposure was 4 (2, 5). The most common morbidities were BPD (41%) and grade III or IV IVH (20%), and overall survival varied from 46% (2006) to 57% (2016).

Conclusions

A large number of medications were used in periviable infants. There was a high prevalence of in-hospital morbidities, and survival of this population increased over the study period.

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Fig. 1: Number of medications and survival by site.
Fig. 2: Survival by GA.

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Acknowledgements

PTN Steering Committee Members: Daniel K. Benjamin Jr., Christoph Hornik, Kanecia Zimmerman, Phyllis Kennel, and Rose Beci, Duke Clinical Research Institute, Durham, NC, USA; Chi Dang Hornik, Duke University Medical Center, Durham, NC, USA; Gregory L. Kearns, Independent; Matthew Laughon, University of North Carolina at Chapel Hill, Chapel Hill, NC USA; Ian M. Paul, Penn State College of Medicine, Hershey, PA, USA; Janice Sullivan, University of Louisville, Louisville, KY, USA; Kelly Wade, Children’s Hospital of Philadelphia, Philadelphia, PA, USA; Paula Delmore, Wichita Medical Research and Education Foundation, Wichita, KS, USA. The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): Perdita Taylor-Zapata and June Lee. The Emmes Company, LLC (Data Coordinating Center): Ravinder Anand, Gaurav Sharma, Gina Simone, Kim Kaneshige, and Lawrence Taylor. PTN Publications Committee: Chaired by Thomas Green, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA

Funding

This work was funded under National Institute of Child Health and Human Development (NICHD) contract (HHSN275201000003I) for the Pediatric Trials Network (PI Daniel K. Benjamin Jr.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. This work was also supported by Duke Clinical Research Institute’s R25 Summer Training in Academic Research (STAR) Program (grant #5R25HD076475–07).

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Author notes

  1. High school or college student affiliated with the Duke Clinical Research Institute Summer Training in Academic Research (STAR) Summer Program (5R25HD076475-07).

Authors and Affiliations

  1. Department of Pediatrics, University of Washington, Seattle, WA, USA

    Mihai Puia-Dumitrescu

  2. Department of Pediatrics, Duke University Medical Center, Durham, NC, USA

    Mihai Puia-Dumitrescu, Noelle Younge, Kanecia O. Zimmerman & Rachel G. Greenberg

  3. Department of Economics, Clemson University, Clemson, SC, USA

    Daniel K. Benjamin

  4. Duke Clinical Research Institute, Durham, NC, USA

    Katie Lawson, Cordelia Hume, Kennedy Hill, Jonathan Mengistu, Aryeona Wilson, Kanecia O. Zimmerman & Rachel G. Greenberg

  5. MEDNAX Center for Research, Education, Quality and Safety, San Antonio, TX, USA

    Kaashif Ahmad

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Contributions

MP-D had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis and contributed to the conception and design of the study, the data analysis, the data interpretation, the manuscript drafting, and the critical revision of the manuscript. NY contributed to the data analysis and interpretation, the manuscript drafting, and the critical revision of the manuscript. DKB contributed to the data interpretation, the manuscript drafting, and the critical revision of the manuscript. KL contributed to the data interpretation, the manuscript drafting, and the critical revision of the manuscript. CH contributed to the data interpretation, the manuscript drafting, and the critical revision of the manuscript. KH contributed to the data interpretation, the manuscript drafting, and the critical revision of the manuscript. JM contributed to the data interpretation, the manuscript drafting, and the critical revision of the manuscript. AW contributed to the data interpretation, the manuscript drafting, and the critical revision of the manuscript. KOZ contributed to the data interpretation, the manuscript drafting, and the critical revision of the manuscript. KA contributed to the data interpretation, the manuscript drafting, and the critical revision of the manuscript. RGG contributed to the conception and design of the study, the supervision, data interpretation, and the critical revision of the manuscript.

Corresponding author

Correspondence to Rachel G. Greenberg.

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Conflict of interest

NY received support from the NIH (K23DK120960). MP-D, DKB, KL, CH, KH, JM, AW, KOZ, KA, and RGG report no relevant disclosures.

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Puia-Dumitrescu, M., Younge, N., Benjamin, D.K. et al. Medications and in-hospital outcomes in infants born at 22–24 weeks of gestation. J Perinatol 40, 781–789 (2020). https://doi.org/10.1038/s41372-020-0614-4

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