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OBJECTIVE: To evaluate the implementation of a systematic approach to improve the resuscitation, stabilization, and admission of infants <  32 weeks gestation and also to ascertain its effect on organization, efficiency, and clinical outcomes during hospitalization. METHODS: Retrospective study involving a multidisciplinary team with checklists, role assignment, equipment organization, step by step protocol, and real time documentation for the care of infants <  32 weeks gestation in the delivery room to the neonatal intensive care unit. Pre-data collection (cases) period was from Aug, 2015 to July, 2017, and post-data collection(controls) period was from Aug, 2017 to Aug, 2019. RESULTS: 337 infants were included (179 cases; 158 controls). Increase surfactant use in the resuscitation room (41% vs. 27%, p = 0.007) and reduction in median time to administer surfactant (34 minutes (range, 6–120) vs. 74 minutes (range, 7–120), p = 0.001) observed in control-group. There was a significant reduction in incidence of bronchopulmonary dysplasia (27% vs. 39%), intraventricular hemorrhage (11% vs. 17%), severe retinopathy of prematurity (3% vs. 9%), and necrotizing enterocolitis (4% vs. 6%), however these results were not statistically significant after controlling for severity of illness. CONCLUSIONS: A systematic approach to the care of infants <  32 weeks gestation significantly improved mortality rates and reduced rates of comorbidities.

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Objective: To evaluate the ASD risk in infants with intraventricular hemorrhage (IVH) using the Modified Checklist for Autism in Toddlers-Revised with Follow Up (M-CHAT-R/F). Study Design: Retrospective cohort study. Infants with IVH admitted to the Baylor Scott & White Health NICU from January 2014 through June 2020. M-CHAT-R/F questionnaire results for ASD risk assessment was used, in addition to the cranial ultrasound findings at NICU discharge.Results: M-CHAT-R/F screening results were found in 165 infants, 80 children had IVH and 85 children had no IVH, 35 infants failed (ASD Risk) and 130 infants passed the M-CHAT-R/F (No-ASD risk). Median birth weight and gestational age were significantly lower in ASD risk group. ASD risk and cerebral palsy were significantly associated with severe IVH. Based on discharge cranial ultrasound findings, ASD risk of infants with resolved IVH was comparable to No-IVH group. Conclusions: The ASD risk increases with lower gestational age, lower birth weight and severe IVH.