Alan H. Jobe, MD, PhD and Eric Gibson, MD
Why do premature infants die? There is currently inadequate information on the causes and timing of death in extremely premature infants, and without identifying an appropriate causality, it will become difficult to improve our interventions.
Although survival among premature infants has improved, prematurity continues to be a leading contributor to neonatal mortality in the United States. Understanding the causes and timing of death in extremely premature infants can help to guide research efforts and inform the counseling of families. In this segment, Dr. Jobe discusses the importance of recognizing that in populations at high risk of death, unanticipated deaths may confound trials because there is generally significant inaccuracy in confirming the causality of neonatal death, meaning that we have inadequate information on why babies actually die. We must recognize that an undesirable outcome may not result from intervention but changes in care associated with intervention. This has substantial implications for future research, as it becomes difficult to change interventions until we can truly understand without truly neonates are dying.