ArticleBMC medicine2018
Intensity of perinatal care, extreme prematurity and sensorimotor outcome at 2 years corrected age: evidence from the EPIPAGE-2 cohort study.
Article in BMC medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- A systematic review of perinatal palliative care models: challenges and opportunities for the future.European journal of pediatrics · 2025Pooled it
- Impact of an intervention standardizing the perinatal management of extremely preterm infants on the child's survival without severe morbidity: a stepped-wedge cluster-randomized trial (PREMEX study).BMC pregnancy and childbirth · 2026Trial
- Intensity of perinatal care for extreme preterm births and neurodevelopmental outcomes at age 5½: the EPIPAGE-2 cohort study.BMJ paediatrics open · 2025Article
- Article
- Changes in perinatal management and outcomes of extremely preterm infants born below 26 weeks of gestation in a tertiary referral hospital in Sweden: Comparison between 2004-2007 and 2012-2016.Acta obstetricia et gynecologica Scandinavica · 2023Article
- Survival and neurodevelopmental impairment of outborn preterm infants at 5.5 years of age: an EPIPAGE-2 prospective, matched study using multiple imputation.BMJ paediatrics open · 2022Article
- Recent historic increase of infant mortality in France: A time-series analysis, 2001 to 2019.The Lancet regional health. Europe · 2022Article
- Management and outcomes of extreme preterm birth.BMJ (Clinical research ed.) · 2022Article
- Birth outcomes between 22 and 26 weeks' gestation in national population-based cohorts from Sweden, England and France.Acta paediatrica (Oslo, Norway : 1992) · 2022Article
- Cohort Profile: the Etude Epidémiologique sur les Petits Ages Gestationnels-2 (EPIPAGE-2) preterm birth cohort.International journal of epidemiology · 2021Article
- Maternal and infant morbidity following birth before 27 weeks of gestation: a single centre study.Scientific reports · 2021Article
- Temporal trends of care practices, morbidity, and mortality of extremely preterm infants over 10-years in South Wales, UK.Scientific reports · 2020Article
- Intensity of perinatal care for extremely preterm babies and outcomes at a higher gestational age: evidence from the EPIPAGE-2 cohort study.BMC pediatrics · 2020Article
Corrections and comments
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Authors and funding
11 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEmerging evidence suggests intensity of perinatal care influences survival for extremely preterm babies. We evaluated the effect of differences in perinatal care intensity between centres on sensorimotor morbidity at 2 years of age. We hypothesised that hospitals with a higher intensity of perinatal care would have improved survival without increased disability.
methodsFoetuses alive at maternal admission to a level 3 hospital in France in 2011, subsequently delivered between 22 and 26 weeks gestational age (GA) and included in the EPIPAGE-2 national prospective observational cohort study formed the baseline population. Level of intensity of perinatal care was assigned according to hospital of birth, categorised into three groups using 'perinatal intensity' ratios (ratio of 24-25 weeks GA babies admitted to neonatal intensive care to foetuses of the same GA alive at maternal admission to hospital). Multiple imputation was used to account for missing data; hierarchical logistic regression accounting for births nested within centres was then performed.
resultsOne thousand one hundred twelve foetuses were included; 473 survived to 2 years of age (126 of 358 in low-intensity, 140 of 380 in medium-intensity and 207 of 374 in high-intensity hospitals). There were no differences in disability (adjusted odds ratios 0.93 (95% CI 0.28 to 3.04) and 1.04 (95% CI 0.34 to 3.14) in medium- and high- compared to low-intensity hospitals, respectively). Compared to low-intensity hospitals, survival without sensorimotor disability was increased in the population of foetuses alive at maternal admission to hospital and in live-born babies, but there were no differences when considering only babies admitted to NICU or survivors.
conclusionsNo difference in sensorimotor outcome for survivors of extremely preterm birth at 2 years of age was found according to the intensity of perinatal care provision. Active management of periviable births was associated with increased survival without sensorimotor disability.
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