Improving NICU outcomes–A worldwide endeavor

Abstract

In this volume of The Journal, D’Apremont et al report on mortality and morbidity outcomes over 15 years (2001-2016) for nearly 14 000 very low birthweight infants (500-1500 grams) at NEOCOSUR centers (30 Neonatal Units from Argentina, Brazil, Chile, Paraguay, Peru, and Uruguay). While many national and international NICU collectives from the US, Canada, Europe, Australia, and Japan have published large scale NICU outcome data, D’Apremont et al provide the first substantial multi-year report from a similar NICU collaborative based in middle-income countries. Despite introducing many evidence-based practices, including increased use of antenatal corticosteroids and noninvasive ventilation, the NEOCOSUR centers did not observe a reduction in mortality in VLBW infants in NICUs. This was probably because of a drop in survival for the most premature babies born at ≤25 weeks gestational age. On the other hand, survival without major morbidity substantially improved for moderately preterm babies >29 weeks gestational age. The NEOCOSUR report demonstrates the ability to collect high quality data from middle-income countries, which is particularly meaningful as neonatal mortality remains stubbornly high in middle- and low-income countries and accounts for over 98% of neonatal mortality worldwide. We hope that NEOCOSUR finds novel ways to compare and contrast their findings with those of high income countries as they continue to improve care for their youngest NICU citizens—these are countries that have learned to walk and deserve to run. Article page 44 ▸ Trends in Perinatal Practices and Neonatal Outcomes of Very Low Birth Weight Infants during a 16-year Period at NEOCOSUR CentersThe Journal of PediatricsVol. 225PreviewTo describe trends in mortality, major morbidity, and perinatal care practices of very low birth weight infants born at NEOCOSUR Neonatal Network centers from January 1, 2001, through December 31, 2016. Full-Text PDF