Extremely preterm births: end-of-life decisions in European countries

To explore the influence of end-of-life decisions (EoL-D) on survival and mortality data in the light of differences reported among European countries. We collected the published data of several epidemiological studies: Epicure, Epipage, Epibel and the Norwegian study performed in the UK, France, Belgium and Norway, respectively. The data concerning the Epibel and Norwegian studies are considered for a preliminary analysis, while the data relating to the Epicure and Epipage studies are compared based on the total published data. The statistical analysis was performed through the class of generalized linear models, and more specifically, through log-linear models. The data considered were the number of babies who died in neonatal intensive care units after active withdrawal classified according to the country and gestational age. The attitude towards EoL-D could in part explain the differences in survival data of extremely preterm infants and should be taken in mind when comparing international survival rates.