Original ArticlesThe effect of transport on the rate of severe intraventricular hemorrhage in very low birth weight infants☆
Section snippets
Materials and methods
Data from all neonates admitted to the newborn intensive care unit (NICU) at Miller Children’s Hospital in association with Long Beach Memorial Women’s Hospital were collected prospectively. The study period was June 1, 1992, through December 31, 1995, and the project was approved by the institutional review board.
Neonatal data collection included gestational age at delivery, birth weight, Apgar scores, mode of delivery, gender, use of rescue surfactant or indomethacin, and overall neonatal
Results
There were 37 cases (11%) of grade III or IV intraventricular hemorrhage in the 329 newborns who met study criteria: 27 of 285 delivered in the level III center (9%), and ten of 44 outborn neonates (23%), a statistically lower difference (P < .02, 95% confidence interval of 0.15, 0.87). Table 1 compares outborn and inborn groups for the total study population. The only significant difference was incidence of severe intraventricular hemorrhage.
Table 2 compares newborns who developed grade III or
Discussion
This study analyzed the incidence of severe intraventricular hemorrhage in VLBW neonates on the basis of birth location by level of institution. Neonatal care for both groups was in the same unit, so neonatal management was controlled. The main areas of difference were obstetric care (antenatal and intrapartum management), neonatal resuscitation, and effect of newborn transport. Our data found that the rate of grade III or IV intraventricular hemorrhage is lower in complicated pregnancies
References (20)
A review of perinatal mortality in Colorado, 1971 to 1978, and its relationship to the regionalization of perinatal services
Am J Obstet Gynecol
(1981)- et al.
Very low-birth weight infant. Influence of place of birth on survival
Am J Obstet Gynecol
(1982) - et al.
Recent changes in delivery site of low-birth-weight infants in WashingtonImpact on birth weight–specific mortality
Am J Obstet Gynecol
(1995) - et al.
Changing patterns in regionalization of perinatal care and the impact on neonatal mortality
Am J Obstet Gynecol
(1998) - et al.
Prevention of intraventricular hemorrhage in the premature infant
Fetal Drug Ther
(1994) - et al.
Risk factor analysis of intraventricular hemorrhage in low-birth-weight infants
J Pediatr
(1981) - et al.
Incidence and evolution of subependymal and intraventricular hemorrhageA study of infants with birth weights less than 1,500 gm
J Pediatr
(1978) - et al.
Umbilical cord blood acid-base stateWhat is normal?
Am J Obstet Gynecol
(1996) Toward improving the outcome of pregnancy. Recommendations for the regional development of perinatal health services
Obstet Gynecol
(1975)- et al.
The regionalization of perinatal services. Summary of the evaluation of a national demonstration program
JAMA
(1985)
Cited by (91)
Disparities in access to healthcare services in a regional neonatal transport network
2024, International Journal of Industrial ErgonomicsPerinatal care for the extremely preterm infant
2022, Seminars in Fetal and Neonatal MedicineCitation Excerpt :A large body of evidence suggests a clear benefit from in-utero transfer of women at risk of preterm birth to and subsequent delivery at a tertiary level centre with high level Neonatal Intensive Care Unit (NICU), this is especially so for very low birth weight infants (below 1500 g) [99–105]. Improved neonatal outcomes include lower mortality rates, significantly shorter ventilator time, less oxygen therapy exposure, shorter NICU admission, lower incidence of severe morbidities including respiratory distress syndrome (RDS), intraventricular haemorrhage (IVH), necrotizing enterocolitis (NEC), patent ductus arteriosus and hospital acquired infections [99,106–108]. The reduction in morbidity and mortality due to delivery in a tertiary centre is inversely related to gestational age [108].
Comparison of inter-facility transports of critically ill neonates who died after admission vs. survivors
2021, Journal of Neonatal NursingCitation Excerpt :In recent decades, pediatric IFT is conducted by specialized transport teams with advanced ventilatory and monitoring capabilities that function as mobile intensive care units, with an improvement in outcomes (Stroud et al., 2013; Orr et al., 2009). Urgent IFT of a critically ill neonate, though, has been shown to be associated with increased death and morbidities such as intra-ventricular hemorrhage in some studies (Araujo et al., 2011; Hohlagschwandtner et al., 2001; Mori et al., 2007; Mohamed and Aly, 2010; Warner et al., 2004; Towers et al., 2000; Arora et al., 2014). Isolated studies have also reported an association between prolonged duration of IFT more than 60 min and mortality (Hohlagschwandtner et al., 2001).
Reducing Infant Mortality Using Telemedicine and Implementation Science
2020, Obstetrics and Gynecology Clinics of North AmericaThreatened preterm birth: Validation of a nomogram to predict the individual risk of very preterm delivery in a secondary care center
2019, Journal of Gynecology Obstetrics and Human Reproduction
- ☆
A portion of this study was funded through the Memorial Research Foundation of Long Beach Memorial Medical Center.