title: The EPIBEL study: outcomes to discharge from hospital for extremely preterm infants in Belgium.
abstract: OBJECTIVE
  To determine mortality and morbidity at discharge from the hospital of a large population-based cohort of infants who were born at <or=26 weeks' gestation.
  
  
  METHODS
  Perinatal data were collected on extremely preterm infants who were alive at the onset of labor and born between January 1, 1999, and December 31, 2000, in all 19 Belgian perinatal centers.
  
  
  RESULTS
  A total of 525 infants were recorded. Life-supporting care was provided to 322 liveborn infants, 303 of whom were admitted for intensive care. The overall survival rate of liveborn infants was 54%. Of the infants who were alive at the age of 7 days, 82% survived to discharge. Vaginal delivery, shorter gestation, air leak, longer ventilator dependence, and higher initial oxygen need all were independently associated with death; gender, plurality, and surfactant therapy were not. Among the 175 survivors, 63% had 1 or more of the 3 major adverse outcome variables at the time of discharge (serious neuromorbidity, chronic lung disease at 36 weeks' postmenstrual age, or treated retinopathy of prematurity). The chance of survival free from serious neonatal morbidity at the time of hospital discharge was <15% (21 of 158) for the admitted infants with a gestation <26 weeks.
  
  
  CONCLUSIONS
  If for the time being prolongation of pregnancy is unsuccessful, then outcome perspectives should be discussed and treatment options including nonintervention explicitly be made available to parents of infants of <26 weeks' gestation within the limits of medical feasibility and appropriateness.
authors.affiliation: Department of Neonatology, University Hospital Ghent, De Pintelaan 185 B-9000 Ghent, Belgium. piet.vanhaesebrouck@ugent.be
authors.forename: Piet
authors.initials: P
authors.lastname: Vanhaesebrouck
authors.forename: Karel
authors.initials: K
authors.lastname: Allegaert
authors.forename: Jean
authors.initials: J
authors.lastname: Bottu
authors.forename: Christian
authors.initials: C
authors.lastname: Debauche
authors.forename: Hugo
authors.initials: H
authors.lastname: Devlieger
authors.forename: Martine
authors.initials: M
authors.lastname: Docx
authors.forename: Anne
authors.initials: A
authors.lastname: François
authors.forename: Dominique
authors.initials: D
authors.lastname: Haumont
authors.forename: Jacques
authors.initials: J
authors.lastname: Lombet
authors.forename: Jacques
authors.initials: J
authors.lastname: Rigo
authors.forename: Koenraad
authors.initials: K
authors.lastname: Smets
authors.forename: Inge
authors.initials: I
authors.lastname: Vanherreweghe
authors.forename: Bart
authors.initials: B
authors.lastname: Van Overmeire
authors.forename: Patrick
authors.initials: P
authors.lastname: Van Reempts
mesh_terms: D001530:Belgium / Q000453:epidemiology; D002423:Cause of Death; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000401:mortality*; D019102:Infant, Very Low Birth Weight / Q000254:growth & development; D007363:Intensive Care Units, Neonatal; D007902:Length of Stay; D016015:Logistic Models; D009099:Multiple Birth Offspring; D010351:Patient Discharge; D011247:Pregnancy; D011248:Pregnancy Complications; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012307:Risk Factors; D015996:Survival Rate