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  1. The influence of the wider use of surfactant therapy on neonatal mortality among blacks and whites.

    Article - En anglais

    Background

    Surfactant therapy reduces morbidity and mortality among premature infants with the respiratory distress syndrome (RDS).

    Fetal pulmonary surfactant matures more slowly in white than in black fetuses, and therefore RDS is more prevalent among whites than among blacks.

    We reasoned that the increased use of surfactant after its approval by the Food and Drug Administration (FDA) in 1990 might have reduced neonatal mortality more among whites than among blacks.

    Methods

    We merged vital-statistics information for all 1563 infants with very low birth weights (500 to 1500 g) born from 1987 through 1989 or in 1991 and 1992 to residents of St.

    Louis with clinical data from the four neonatal intensive care units in the St.

    Louis area ; we then compared neonatal mortality during two periods, one before and one after the FDA's approval of surfactant for clinical use (1987 through 1989 and 1991 through 1992).

    Results

    The use of surfactant increased by a factor of 10 between 1987 through 1989 and 1991 through 1992.

    The neonatal mortality rate among all very-low-birth-weight infants decreased 17 percent, from 220.3 deaths per 1000 very-low-birth-weight babies born alive (in 1987 through 1989) to 183.9 per 1000 (in 1991 through 1992 ; P=0.07).

    This decrease was due to a 41 percent reduction in the mortality rate among white newborns with very low birth weights (from 261.5 per 1000 to 155.5 per 1000 ; P=0.003). (...)

    Mots-clés Pascal : Surfactant pulmonaire, Chimiothérapie, Poids naissance très faible, Détresse respiratoire, Aigu, Epidémiologie, Etude comparative, Mortalité, Prévention, Nouveau né, Homme, Race, Prématuré, Gestation pathologie, Nouveau né pathologie, Appareil respiratoire pathologie

    Mots-clés Pascal anglais : Pulmonary surfactant, Chemotherapy, Very low birthweight, Respiratory distress, Acute, Epidemiology, Comparative study, Mortality, Prevention, Newborn, Human, Race, Premature, Pregnancy disorders, Newborn diseases, Respiratory disease

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 96-0321172

    Code Inist : 002B11D. Création : 10/04/1997.