{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:13:29Z","timestamp":1760148809541,"version":"build-2065373602"},"reference-count":35,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,7,29]],"date-time":"2022-07-29T00:00:00Z","timestamp":1659052800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Extremely preterm infants were at increased risk of mortality and morbidity. The purpose of this study was to: (1) examine changes over time in perinatal management, mortality, and major neonatal morbidities among infants born at 250\u2013286 weeks\u2019 gestational age and cared for at one Romanian tertiary care unit and (2) compare the differences with available international data. Material and Methods: This study consisted of infants born at 250\u2013286 weeks in one tertiary neonatal academic center in Romania during two 4-year periods (2007\u20132010 and 2015\u20132018). Major morbidities were defined as any of the following: severe intraventricular hemorrhage (IVH), severe retinopathy of prematurity (ROP), necrotizing enterocolitis (NEC), and bronchopulmonary dysplasia (BPD). Adjusted logistic regression models examined the association between the mortality and morbidity outcome and the study period. Results: The two cohorts differed with respect to antenatal antibiotics and rates of cesarean birth but had similar exposure to antenatal steroids and newborn referral to the tertiary care center. In logistic regression analyses, infants in the newer compared to the older cohort had a lower incidence of death (OR: 0.19; 95% CI: 0.11\u20130.35), a lower incidence of IVH (OR: 0.26; 95% CI: 0.15\u20130.46), and increased incidence of NEC (OR: 19.37; 95% CI: 2.41\u2013155.11). Conclusions: Changes over time included higher use of antenatal antibiotics and cesarean delivery and no change in antenatal steroids administration. Overall mortality was lower in the newer cohort, especially for infants 250\u2013266 weeks\u2019 gestation, NEC was higher while BPD and ROP were not different.<\/jats:p>","DOI":"10.3390\/medicina58081019","type":"journal-article","created":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T02:06:42Z","timestamp":1659319602000},"page":"1019","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Changes Overtime in Perinatal Management and Outcomes of Extremely Preterm Infants in One Tertiary Care Romanian Center"],"prefix":"10.3390","volume":"58","author":[{"given":"Diana","family":"Ungureanu","sequence":"first","affiliation":[{"name":"Neonatology Department, Maternity Hospital \u201cIoan Aurel Sb\u00e2rcea\u201d, 500025 Brasov, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nansi S.","family":"Boghossian","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8743-4562","authenticated-orcid":false,"given":"Laura Mihaela","family":"Suciu","sequence":"additional","affiliation":[{"name":"Department of Neonatology, University of Medicine Pharmacy Science and Technology \u201cGeorge Emil Palade\u201d of T\u00e2rgu Mure\u0219, 540139 T\u00e2rgu Mure\u0219, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/S0140-6736(08)60380-3","article-title":"Neurodevelopmental disabilities and special care of 5-year-old children born before 33 weeks of gestation (the EPIPAGE study): A longitudinal cohort study","volume":"371","author":"Larroque","year":"2008","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1001\/jamapediatrics.2014.3351","article-title":"Survival and morbidity of preterm children born at 22 through 34 weeks\u2019 gestation in France in 2011: Results of the EPIPAGE-2 cohort study","volume":"169","author":"Ancel","year":"2015","journal-title":"JAMA Pediatr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e20180933","DOI":"10.1542\/peds.2018-0933","article-title":"Survival and impairment of extremely premature infants: A meta-analysis","volume":"143","author":"Myrhaug","year":"2019","journal-title":"Pediatrics"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2162","DOI":"10.1016\/S0140-6736(12)60820-4","article-title":"National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: A systematic analysis and implications","volume":"379","author":"Blencowe","year":"2012","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1542\/peds.2009-2959","article-title":"Neonatal outcomes of extremely preterm infants from the NICHD Neonatal Research Network","volume":"126","author":"Stoll","year":"2010","journal-title":"Pediatrics"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1056\/NEJMoa1605566","article-title":"Eunice Kennedy Shriver National Institute of Child Health and Human Development neonatal research network. 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