title: Deaths in preterm infants: changing pathology over 2 decades.
abstract: OBJECTIVE
  To establish how cause of death for live-born preterm infants (24-31 weeks gestation) has changed in a single large UK population over 2 decades.
  
  
  METHODS
  This was an interrogation of a population-based survey of >680, 000 live births (between 1988 and 2008) for deaths in the first postnatal year. We collected cause of death grouped into major etiologies: respiratory, infection, malformation, necrotizing enterocolitis (NEC), and other. Data were analyzed in three 7-year epochs and 2 gestational groups (<27 and 28-31 weeks). Numbers, rates per 1000 live births, and proportional contributions to each epoch were analyzed.
  
  
  RESULTS
  A total of 1504 deaths occurred. The infants who died had a median gestational age of 26 weeks (IQR, 25-28 weeks) and a median birth weight of 880 g (IQR, 700-1170 g). The number of deaths decreased with each later epoch (from 671 to 473 and then to 360), as did the proportion of deaths from respiratory causes (64% to 62% and then to 49%). The proportion of deaths occurring after 40 weeks postmenstrual age remained stable across the 3 epochs (8.8%, 8%, and 8%). Deaths from infection and NEC increased with time (from 11% to 13% and then to 21%), as did median time to death (from 2.7 to 3.8 days).
  
  
  CONCLUSIONS
  Infection and NEC are increasingly prevalent causes of death in preterm infants.
authors.affiliation: Newcastle Neonatal Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK. janet.berrington@nuth.nhs.uk
authors.forename: Janet Elizabeth
authors.initials: JE
authors.lastname: Berrington
authors.forename: Richard Iain
authors.initials: RI
authors.lastname: Hearn
authors.forename: Mary
authors.initials: M
authors.lastname: Bythell
authors.forename: Chris
authors.initials: C
authors.lastname: Wright
authors.forename: Nicholas David
authors.initials: ND
authors.lastname: Embleton
mesh_terms: D002423:Cause of Death / Q000639:trends; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000401:mortality*; D013997:Time Factors; D006113:United Kingdom / Q000453:epidemiology