Book contents
- Frontmatter
- Contents
- Part 1 THE EXTREMELY PRETERM INFANT: EPIDEMIOLOGY, PERCEPTIONS, AND PRACTICES
- 1 Introduction
- 2 Historical Aspects
- 3 Survival
- 4 Influence of Obstetric Management
- 5 Effect of Resuscitation in the Delivery Room
- 6 National Comparisons
- 7 Prediction of Outcome
- 8 Limit of Viability
- 9 Morbidity
- 10 School Age Outcome
- 11 Adolescence
- 12 Perceptions and Practices
- 13 Resource Expenditure
- Part 2 BIOETHICS
- Part 3 REPORTS, OFFICIAL OPINIONS, AND GUIDELINES
- Part 4 THE LAW
- Part 5 EPILOGUE: TRUTH, TRUST, AND BOUNDARIES
- References
- Index
6 - National Comparisons
Published online by Cambridge University Press: 23 September 2009
- Frontmatter
- Contents
- Part 1 THE EXTREMELY PRETERM INFANT: EPIDEMIOLOGY, PERCEPTIONS, AND PRACTICES
- 1 Introduction
- 2 Historical Aspects
- 3 Survival
- 4 Influence of Obstetric Management
- 5 Effect of Resuscitation in the Delivery Room
- 6 National Comparisons
- 7 Prediction of Outcome
- 8 Limit of Viability
- 9 Morbidity
- 10 School Age Outcome
- 11 Adolescence
- 12 Perceptions and Practices
- 13 Resource Expenditure
- Part 2 BIOETHICS
- Part 3 REPORTS, OFFICIAL OPINIONS, AND GUIDELINES
- Part 4 THE LAW
- Part 5 EPILOGUE: TRUTH, TRUST, AND BOUNDARIES
- References
- Index
Summary
Outcomes for the EPTI may differ from country to country; the reasons include economic resources and access to sophisticated technological care in developing countries and varying attitudes and perceptions in the more developed countries. The latter will be discussed later in this chapter, but here I briefly document findings concerning the Netherlands and survival in some developing countries. Lorenz et al.(22) reported on the outcome of EPTIs born less than 26 weeks in two population-based cohorts, New Jersey (NJ), United States and the Netherlands, who received systematically different approaches to their care during the mid-1980s. In the NJ cohort, almost all babies received intensive care, whereas the policy was more selective in the Netherlands. Assisted ventilation was more commonly used in NJ, 95% versus 64%, and almost all the difference resulted from the use of assisted ventilation in infants who subsequently died. Mortality at 28 days was about 46% in NJ and 73% in the Netherlands. No infant less than 25 weeks' gestation survived to 28 days in the Netherlands. Survival to 2 years in NJ was twice that in the Netherlands. The prevalence of disabling cerebral palsy was 17.2% among survivors in NJ and 3.4% in the Netherlands. In the NJ cohort, 1,820 ventilator days were expended per 100 live births compared to 448 days in the Netherlands, but the difference in nonventilator days was not statistically different.
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- Extreme PrematurityPractices, Bioethics and the Law, pp. 20 - 22Publisher: Cambridge University PressPrint publication year: 2006