Browsing by Author "San Feliciano, Laura"

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    Factors associated with survival and survival without major morbidity in very preterm infants in two neonatal networks: SEN1500 and NEOCOSUR
    (S. Karger A.G., 2021) García-Muñoz Rodrigo, Fermín; Fabres Biggs, Jorge Guillermo Eduardo; Tapia Illanes, José Luis; D'apremont Ormeño, Ivonne; San Feliciano, Laura; Zozaya Nieto, Carlos; Figueras Aloy, Josep; Mariani, Gonzalo; Musante, Gabriel; Silvera, Fernando; Zegarra, Jaime; Vento, Máximo
    Introduction: Very low-birth weight (VLBW) infants represent a high-risk population for morbidity and mortality in the neonatal period. Variability in practices and outcomes between centers has been acknowledged. Multicenter benchmarking studies are useful to detect areas of improvement and constitute an interesting research tool. Objectives: The aim of the study was to determine the perinatal variables and interventions associated with survival and survival without major morbidity in VLBW infants and compare the performance of 2 large networks. Methods: This is a prospective study analyzing data collected in 2 databases, the Spanish SEN1500 and the South American NEOCOSUR networks, from January 2013 to December 2016. Inborn patients, from 24(0) to 30(6) weeks of gestational age (GA) were included. Hazard ratios for survival and survival without major morbidity until the first hospital discharge or transfer to another facility were studied by using Cox proportional hazards regression. Results: A total of 10,565 patients, 6,120 (57.9%) from SEN1500 and 4,445 (42.1%) from NEOCOSUR, respectively, were included. In addition to GA, birth weight, small for gestational age (SGA), female sex, and multiple gestation, less invasive resuscitation, and the network of origin were significant independent factors influencing survival (aHR [SEN1500 vs. NEOCOSUR]: 1.20 [95% CI: 1.15-1.26] and survival without major morbidity: 1.34 [95% CI: 1.26-1.43]). Great variability in outcomes between centers was also found within each network. Conclusions: After adjusting for covariates, GA, birth weight, SGA, female sex, multiple gestation, less invasive resuscitation, and the network of origin showed an independent effect on outcomes. Determining the causes of these differences deserves further study.
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    Survival and Survival without Major Morbidity Seem to Be Consistently Better throughout Gestational Age in 24-to 30-Week Gestational Age Very-Low-Birth-Weight Female Infants Compared to Males
    (2022) Garcia-Munoz Rodrigo, Fermin; Fabres, Jorge G.; Zozaya Nieto, Carlos; San Feliciano, Laura; Figueras-Aloy, Josep; Saenz de Pipaon, Miguel; D'Apremont, Ivonne; Genes de Lovera, Larissa E.; Bancalari, Aldo; Tapia, Jose L.; Vento, Maximo
    Introduction: Several studies showed advantages in outcomes for very-low-birth-weight (VLBW) female infants. It has been suggested that recent advances in perinatal care might have benefited boys relatively more than girls, making differences disappear. Objectives: The aims of the study were (1) to determine if sex differences in survival and survival without morbidity in VLBW infants are still present in the context of more advanced perinatal care and (2) to know whether these differences are consistent throughout gestational age (GA). Methods: Retrospective cohort study in seven countries participating in the Spanish SEN1500 and the South American NEOCOSUR neonatal networks. We included VLBW infants 24-30 weeks' GA, born alive without major congenital anomalies (2013-2016). Major morbidity, survival, and survival without morbidity were compared between male and female infants overall and stratified by GA. Results: 10,565 patients were included: 5,620 (53.2%) males and 4,945 (46.8%) females. Female infants exhibited a lower incidence rate ratio (95% CI) of respiratory distress syndrome: 0.91 (0.88, 0.94), necrotizing enterocolitis: 0.83 (0.74, 0.93), major brain damage: 0.79 (0.72, 0.86), moderate-severe bronchopulmonary dysplasia (BPD): 0.77 (0.72, 0.83), higher survival: 1.03 (1.01, 1.05), survival without BPD: 1.11 (1.07, 1.16), survival without major brain damage: 1.05 (1.02, 1.08), and survival without major morbidity: 1.14 (1.07, 1.21). Survival and survival without morbidity were almost consistently favourable to females throughout GA. Conclusions: Our findings suggest that perinatal results continue to be favourable for VLBW female infants in the context of current perinatology, and that they are almost consistent throughout GA.