Research Article

Impact of Changes in Perinatal Care on Neonatal Respiratory Outcome and Survival of Preterm Newborns: An Overview of 15 Years

Table 1

Demographics and clinical data.

Total 
1997–2004 
2005–2011 

Gender, (%)
 Male197 (49.9)120 (60)77 (39.5)<0.0001*
 Female198 (50.1)80 (40)118 (60.5)
Gestational age (weeks), mean (±SD)29.1 (2.9)28.9 (3.2)29.3 (2.6)0.15¥
Birth weight (grams), median (min–max)1130 (360–1498)1120 (460–1495)1130 (360–1498)0.958¥
Small for gestational age, (%)95 (24.1)42 (21)53 (27.2)0.15*
Less than 1000 g, (%)156 (40)83 (41.4)73 (37.4)0.409*
Antenatal steroids, (%)325 (82.3)153 (76.5)172 (88.2)
 Dexamethasone161 (49.5)152 (99.3)9 (5.2)<0.0001*
 Betamethasone164 (50.5)1 (0.7)163 (94.8)
 Full cycle213 (65.5)74 (48.4)139 (80.8)<0.0001*
 Incomplete cycle112 (34.5)79 (51.6)33 (19.2)
Histological chorioamnionitis, (%)111 (28)53 (26.5)58 (29.7)0.364*
Delivery mode, (%)
 Vaginal147 (37.2)87 (43.5)60 (30.8)0.009*
 C-section248 (62.8)113 (56.5)135 (69.2)
Apgar score, (%)
1st minute
 ≤7283 (71.6)170 (85)113 (57.9)<0.0001*
 ≥8112 (28.4)30 (15)82 (42.1)
5th minute
 ≤7140 (35.4)92 (46)48 (24.6)
 ≥8225 (64.6)108 (54)147 (75.4)
Respiratory management in the delivery room, (%)
 Endotracheal intubation229 (58)150 (75)79 (40.5)<0.0001*
 Spontaneous ventilation110 (27.8)50 (25)60 (30.8)0.201*
 Early NCPAP56 (14.2)056 (28.7)<0.0001*
Respiratory distress syndrome, n (%)247 (62.5)132 (66) 115 (59)0.15*
Surfactant administration method, n (%)217 (54.9)112 (56)105 (53.8)0.667*
 Endotracheal intubation with mechanical
 ventilation
202 (93)112 (56)90 (85.7)
 INSURE14 (6.5)014 (13.3)<0.0001
 Both methods1 (0.5)01 (1)
Invasive mechanical ventilation, n (%)250 (63.3)149 (75.3)101 (51.8)<0.0001*
Invasive mechanical ventilation, median day (min–max)6 (1–184)6 (1–184)5 (1–140)0.44¥
NCPAP, n (%)221 (55.9)67 (33.5)154 (79.4)<0.0001*
NCPAP, median day (min–max)12 (1–75)10 (1–50)13.5 (1–75)0.049 ¥
Oxygen, n (%)272 (68.9)152 (76)120 (61.5)0.002 *
Oxygen, median day (min–max)4 (1–184)7 (1–184)2 (1–147)<0.0001 ¥
NICU stay, median day (min–max)42 (1–184)39 (1–184)45 (1–160)0.006 ¥
Bronchopulmonary dysplasia, (%)33 (8.4)23 (11.5)10 (5.1)0.022 *
Patent ductus arteriosus (PDA), (%)115 (29.1)60 (30)55 (28)0.340*
Surgical closure of PDA15 (3.7)8 (4)7 ( 3.5) 0.257*
Nosocomial sepsis, (%)107 (27) 66 (33) 41 (21)0.089*
Necrotizing enterocolitis ≥ 2A, (%)13 (3.2) 6 (3.0) 7 (3.5) 0.534*
Retinopathy of prematurity ≥ 2, (%)15 (3.7) 8 (4) 7 (3.6) 0.257*
Intraventricular hemorrhage III-IV, (%)22 (5.5) 6 (8.8) 16 (8.2) 0.736*
Cystic periventricular leukomalacia, (%)36 (9.1) 27 (13.5) 9 (4.6) 0.065*
Deceased, (%)91 (23)70 (35)21 (10.8)<0.0001*

*Chi-squared test; ¥Mann-whitney U test; Fisher’s exact test; SD: standard deviation; NCPAP: nasal continuous positive airway pressure; INSURE: intubation surfactant extubation; nicu: neonatal intensive care unit.