Short report Abdel-Latif ME, Kecskés Z, Bajuk B. Arch Dis Child Fetal Neonatal Ed (2011). doi:10.1136/adc.2011.210856 F1 of 5 1 Department of Neonatology, Canberra Hospital, Garran, Australian Capital Territory, Australia 2 Department of Neonatology, The Clinical School, The Australian National University Medical School, PO Box 11, Woden, ACT 2006, Australia 3 Neonatal Intensive Care Units’ (NICUs’) Data Collection, NSW Pregnancy and Newborn Services Network, Westmead, New South Wales, Australia 4 School of Public Health, University of Sydney, Camperdown, New South Wales, Australia Correspondence to Associate Professor Mohamed E Abdel-Latif, Department of Neonatology, The Australian National University Medical School, PO Box 11, Woden, ACT 2606, Australia; abdel-latif.mohamed@ act.gov.au Accepted 30 June 2011 ABSTRACT Objective To characterise the actuarial day-by-day survival of premature infants in a geographically defined population. Setting 10 Neonatal Intensive Care Units (NICUs) in New South Wales (NSW) and Australian Capital Territory (ACT), Australia. Design Retrospective analysis of prospectively collected data as part of NICUs’ data collection in NSW and ACT. Subjects Premature infants born at 22 +0 to 31 +6 weeks’ gestation between January 1997 and December 2006 and admitted to one of the 10 NICUs in NSW and ACT. Outcome Actuarial day-by-day survival to discharge from NICU. Results Survival to discharge after initiation of neonatal intensive care ranges from 30.0% at 23 weeks’ gestation to 98.8% at 31 weeks. Actuarial day-by-day survival increased across all gestations. This improvement was most notable among the babies who were born <26 weeks gestation. Conclusion Preterm infants who survive the first few postnatal days have considerable chances of long-term survival. It is important to revise the information stored regarding chances of survival so it covers chances at regular intervals, especially after the first few days of life. INTRODUCTION Establishing data for survival of premature infants by gestational age is important for counselling parents both prenatally and postnatally. 1 2 Overall survival to discharge of premature infants, unlike actuarial day-by-day survival, is well studied and has been published for babies in different popu- lations. 3 Overall, survival is provided as a single survival rate from admission to discharge for each birthweight or gestational age category. 2 4 Actuarial survival, on the other hand, is provided as day-by-day survival from the time of admission and is important for consultation with parents of infants during their stay in the Neonatal Intensive Care Unit (NICU). 3 The purpose of this study was to characterise the actuarial survival to discharge in a large cohort of preterm infants (22 +0 to 31 +6 weeks’ gestation) admitted to any of the regional NICUs within the network in New South Wales (NSW) or the Australian Capital Territory (ACT), Australia, between 1997 and 2006. Furthermore, we aimed to examine the effect of sex and increasing post- natal age on predicted survival. Actuarial day-by-day survival rates of preterm infants admitted to neonatal intensive care in New South Wales and the Australian Capital Territory Mohamed E Abdel-Latif, 1,2 Zsuzsoka Kecskés, 1,2 Barbara Bajuk 3,4 ; On behalf of the NSW and the ACT Neonatal Intensive Care Audit Group METHODS AND SUBJECTS Data source Perinatal survival and other outcome data for infants of 22 +0 to 31 +6 weeks’ gestation were extracted from the NICUs data collection, which is a population-based, prospectively collected, statewide data collection of neonates admitted to all 10 NICUs (8 perinatal centres and 2 children’s hospitals) in NSW and ACT. Data are prospectively collected and organised within each NICU by a designated clinical nurse specialist using standard operational definitions across the network (B Bajuk, T Vincent, unpublished observation). The data are then compiled into a central database located at the NSW Pregnancy and Newborn Services Network, where rigorous quality control procedures are applied to ensure the accuracy of the data collec- tion. 5 In Australia, it has been recommended by the National Health and Medical Research Council that “Wherever possible preterm birth at <33 weeks should occur in a perinatal centre that has the expertise to care for the woman and her preterm infant.” 6 In general, preterm infants <33 weeks who are born in non-tertiary hospitals are transferred to tertiary centres by a specialised neonatal and paedi- atric emergency transport service team. 7 8 Definitions Chronic lung disease (CLD) is defi ned as the need for supplementary oxygen and/or ventila- tory support at 36 weeks postmenstrual age. 9 10 Intraventricular haemorrhage (IVH) grading is What is already known on this topic Overall survival to discharge, unlike actuarial day- by-day survival, for premature infants of different populations is well studied. What this study adds ▶ Among infants < 26 weeks’ gestation admitted to the Neonatal Intensive Care Unit (NICU), day-by-day actuarial survival rate increases during the first few days of life. ▶ Revising the chances of survival during the early NICU course would improve counselling for parents. ADC-FNN Online First, published on August 9, 2011 as 10.1136/adc.2011.210856 Copyright Article author (or their employer) 2011. Produced by BMJ Publishing Group Ltd (& RCPCH) under licence. group.bmj.com on March 4, 2012 - Published by fn.bmj.com Downloaded from