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Am J Perinatol
DOI: 10.1055/a-2435-0908
Original Article

Trends in the Mortality and Death of Periviable Preterm Infants in the United States, 2011 to 2020

Jenil Patel
1   Department of Epidemiology, Human Genetics and Environmental Sciences, UT Health Houston School of Public Health, Dallas, Texas
,
Omobola Oluwafemi
2   Department of Epidemiology, Human Genetics and Environmental Sciences, UT Health Houston School of Public Health, Houston, Texas
,
Tiffany Tang
3   School of Natural Sciences, Rice University, Houston, Texas
,
Angel Sunny
4   Department of Pediatrics, Elmhurst Hospital Center, Icahn School of Medicine at Mount Sinai, New York
,
Narendrasinh Parmar
5   Section of Emergency Medicine, East Tennessee Children's Hospital, Knoxville, Tennessee
,
Harshit Doshi
6   Division of Neonatology, Golisano Children's Hospital of Southwest Florida, Fort Myers, Florida
,
Parth Bhatt
7   Division of Neonatology, Cincinnati Children's Medical Center, Cincinnati, Ohio
,
Keyur Donda
8   Division of Neonatology, Department of Pediatrics, University of South Florida, Tampa, Florida
,
Sarah E. Messiah
1   Department of Epidemiology, Human Genetics and Environmental Sciences, UT Health Houston School of Public Health, Dallas, Texas
,
Fredrick Dapaah-Siakwan 
9   Departments of Neonatology and Graduate Medical Education, Valley Children's Hospital, Madera, California
› Author Affiliations Funding None.
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Abstract

Objective This study aimed to examine the trends in the infant mortality rate (IMR) and the trends in the timing of death among periviable preterm infants at 22 to 24 weeks' gestational age (GA) in the United States from 2011 to 2020.

Study Design Retrospective, serial cross-sectional analysis of periviable preterm infants born in the United States at 22 to 24 weeks' GA using the linked birth/infant death records from the Centers for Disease Control and Prevention. Data were analyzed from 2011 to 2020. The exposure was the year of death, and the outcome was the changes over time in the IMR and the timing of death. Further, we evaluated racial differences in the timing of death. We used nonparametric trend analysis to evaluate changes in mortality rate across the study period.

Results The IMR was inversely related to GA, and for each GA and race/ethnicity, the IMR significantly declined during the study period. The IMR rate was highest in the first 7 days of life for all GAs and races/ethnicities. While Non-Hispanic White infants had a higher infant neonatal mortality rate than non-Hispanic Black infants, non-Hispanic Black infants had a higher postneonatal mortality rate.

Conclusion The IMR among periviable infants born at 22 to 24 weeks' GA improved for all GAs and races in the United States between 2011 and 2020. However, significant racial differences in the timing of death exist.

Key Points

  • As expected, the IMR was inversely related to gestational age at 22 to 24 weeks.

  • At each gestational age and for each racial/ethnic group, the overall IMR decreased during the study period.

  • Non-Hispanic White infants had a higher neonatal mortality rate, whereas non-Hispanic Black infants had a higher postneonatal mortality rate.

Keywords

neonatology - periviable newborn - racial/ethnic disparities - mortality - periviable births - trends


Publication History

Received: 26 January 2024

Accepted: 05 October 2024

Article published online:
12 November 2024

© 2024. Thieme. All rights reserved.

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