Active perinatal care of preterm infants in the German Neonatal Network

Alexander Humberg*, Christoph Härtel, Tanja K. Rausch, Guido Stichtenoth, Philipp Jung, Christian Wieg, Angela Kribs, Axel Von Der Wense, Ursula Weller, Thomas Höhn, Dirk M. Olbertz, Ursula Felderhoff-Müser, Rainer Rossi, Norbert Teig, Friedhelm Heitmann, Susanne Schmidtke, Bettina Bohnhorst, Matthias Vochem, Hugo Segerer, Jens MöllerJoachim G. Eichhorn, Jürgen Wintgens, Ralf Böttger, Mechthild Hubert, Michael Dördelmann, Georg Hillebrand, Claudia Roll, Reinhard Jensen, Michael Zemlin, Michael Mögel, Claudius Werner, Stefan Schäfer, Thomas Schaible, Axel Franz, Michael Heldmann, Silke Ehlers, Olaf Kannt, Thorsten Orlikowsky, Hubert Gerleve, Katja Schneider, Roland Haase, Kai Böckenholt, Knud Linnemann, Egbert Herting, Wolfgang Göpel

*Corresponding author for this work
7 Citations (Scopus)


Objective: To determine if survival rates of preterm infants receiving active perinatal care improve over time. Design: The German Neonatal Network is a cohort study of preterm infants with birth weight <1500 g. All eligible infants receiving active perinatal care are registered. We analysed data of patients discharged between 2011 and 2016. Setting: 43 German level III neonatal intensive care units (NICUs). Patients: 8222 preterm infants with a gestational age between 22/0 and 28/6 weeks who received active perinatal care. Interventions: Participating NICUs were grouped according to their specific survival rate from 2011 to 2013 to high (percentile >P75), intermediate (P25-P75) and low (<P25) survival. We compared these survival rates with data in 2014-2016. Main outcome measures: Death by any cause before discharge. Results: Total survival increased from 85.8% in 2011-2013 to 87.4% in 2014-2016. This increase was due to reduced mortality of NICUs with low survival rates in 2011-2013. Survival increased in these centres from 53% to 64% in the 22-24 weeks strata and from 73% to 84% in the 25-26 weeks strata. Conclusions: Our data support previous reports that active perinatal care of very immature infants improves outcomes at the border of viability and survival rates at higher gestational ages. The high total number of surviving infants below 24 weeks of gestation challenges national recommendations exclusively referring to gestational age as the single criterion for providing active care. However, more data are needed before recommendations for parental counselling should be reconsidered. Trial registration: Approval by the local institutional review board for research in human subjects of the University of Lübeck (file number 08-022) and by the local ethic committees of all participating centres has been given.

Original languageEnglish
JournalArchives of Disease in Childhood: Fetal and Neonatal Edition
Issue number2
Pages (from-to)190-195
Number of pages6
Publication statusPublished - 19.02.2020

Research Areas and Centers

  • Academic Focus: Center for Brain, Behavior and Metabolism (CBBM)


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