Neonatal Intensive Care Unit Characteristics Affect the Incidence of Severe Intraventricular Hemorrhage

Synnes, Anne; MacNab, Ying C.; Qiu, Zhenguo; Ohlsson, Arne; Gustafson, Paul; Dean, C. B.; Lee, Shoo K.

doi:10.1097/01.mlr.0000218780.16064.df

Cited by 93 publications

(69 citation statements)

References 18 publications

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“…1,4,5,6,23,24,25,26 This study's mortality rates were similar to rates found in other institutions 27 . Though this study was carried out over a short period of time with a small sample size, our results suggest a reduction in overall mortality in non-NICU-TM hospitals (Table 2).…”

Section: Discussionsupporting

confidence: 70%

Telemedicine Collaboration Improves Perinatal Regionalization and Lowers Statewide Infant Mortality

Kim

Teague-Ross

Greenfield

et al. 2014

Obstetrical &Amp; Gynecological Survey

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OBJECTIVES-We assessed a telemedicine (TM) network's effects on decreasing deliveries of very low birth-weight (VLBW, <1500 grams) neonates in hospitals without Neonatal Intensive Care Units (NICUs) and statewide infant mortality.STUDY DESIGN-This prospective study used obstetrical and neonatal interventions through TM consults, education, and census rounds with 9 hospitals from July 1, 2009 -March 31, 2010. Using a generalized linear model, Medicaid data compared VLBW birth sites, mortality, and morbidity before and after TM use. Arkansas Health Department data and chi square analysis were used to compare infant mortality.RESULTS-Deliveries of VLBW neonates in targeted hospitals decreased from 13.1% to 7.0% (p=0.0099); deliveries of VLBW neonates in remaining hospitals was unchanged. Mortality decreased in targeted hospitals (13.0% before TM and 6.7% after TM). Statewide infant mortality decreased from 8.5 to 7.0 per 1000 deliveries (p=0.043).CONCLUSIONS-TM decreased deliveries of VLBW neonates in hospitals without NICUs and was associated with decreased statewide infant mortality..

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Section: Discussionsupporting

confidence: 70%

Telemedicine Collaboration Improves Perinatal Regionalization and Lowers Statewide Infant Mortality

Kim

Teague-Ross

Greenfield

et al. 2014

Obstetrical &Amp; Gynecological Survey

View full text Add to dashboard Cite

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“…In addition to the association between high hospital level and decreased mortality of VLBWI [4][5][6], high patient volumes have been associated with decreased mortality [4,38] and rate of severe intraventricular haemorrhages (IVH) in VLBWI [39]. As shown in our previous study [5], VLBWI born in level III hospitals had lower 1-year mortality rates than those born in level II hospitals.…”

Section: Discussionmentioning

confidence: 76%

Development and behaviour of 5-year-old very low birthweight infants

Rautava

Andersson

Gissler

et al. 2010

Eur Child Adolesc Psychiatry

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The place and time of birth influence the mortality of premature infants. We studied the effect of prematurity, time of birth, birth hospital level and district on the development and behaviour in a national cohort of 5-year-old Finnish very low birthweight infants (VLBWI). All surviving VLBWI (gestational age \32 weeks or birthweight B1,500 g) born in 2001-2002 in level II or III hospitals in Finland and full-term controls were included. The parents of 588 (64%) VLBWI and 176 (46%) controls returned the Five to Fifteen questionnaire (FTF) on the development and behaviour of their 5-year-old children. The questionnaire scores were linked to data from the National Medical Birth Register, the Hospital Discharge Register, the Register of Congenital Malformations and the Cause of Death Register. VLBWI had lower developmental and behavioural scores compared to the controls in all FTF domains. In VLBWI, the scores were less optimal, the lower the gestational age was. The time of birth, birth hospital level and district were not associated with the developmental and behavioural scores in VLBWI. In conclusion, short duration of pregnancy adversely influences development and behaviour in VLBWI. Despite differences previously demonstrated in mortality related to time and place of birth, there were no differences in developmental and behavioural scores in VLBWI according to the time of birth, birth hospital level or district. Thus, the survival advantage in level III hospitals seems not to be gained at the expense of behavioural or developmental problems.

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“…Foram feitos investimentos consideráveis na aquisição de equipamentos e na contratação de médicos e enfermeiros, e também foi dado início ao programa de regionalização do atendimento neonatal. Synnes et al demonstraram que a incidência de HPIV grave em 17 unidades neonatais canadenses não estava relacionada apenas às características dos recém-nascidos, mas também, e de modo importante, aos aspectos estruturais da organização das unidades, incluindo pessoal, relação do número de profissionais por leito e existência de serviços especializados 21 .…”

Section: Discussionunclassified

“…Tais práticas estão englobadas no que tem sido denominado como implementação de melhores práticas para prevenção de hemorragia cerebral e lesão cerebral isquêmica em recém-nascidos de muito baixo peso ao nascer [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] .…”

Section: Discussionunclassified

Incidence of periventricular/intraventricular hemorrhage in very low birth weight infants: a 15-year cohort study

Marba¹,

Caldas²,

Vinagre³

et al. 2011

J Pediatr (Rio J)

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Objective: To assess the incidence of periventricular/intraventricular hemorrhage (PIVH) in very low birth rate neonates. Methods:This was a prospective cohort study conducted on a sample of very low birth weight infants over a 15-year period. Neonates who did not undergo cerebral ultrasonography, had malformations affecting the central nervous system, or died within the first 24 hours of life were excluded. Ultrasonography was performed through the anterior fontanelle using an Aloka ® 620 scanner with a 5 mHz probe, between days 1 and 3 of life, at 7 days, and at 28 days (or at discharge). Incidence was analyzed by means of the chi-square test for trend or Cochran-Armitage test and through a simple linear regression model with a logarithmic trendline as the output. For assessment of potential associated factors, a variety of obstetric, perinatal, and neonatal data collected between 1991-1994 and 2002-2005 were analyzed, using the chi-square and Fisher's exact tests for statistical analysis. The significance level was set at 5%.Results: Of 1,777 very low birth weight infants born during the study period, 1,381 (77.7%) were examined. Of these, 289 (20.9%) had PIVH. The yearly distribution of cases showed a progressive decline in incidence, from 50.9% in 1991 to 11.9% in 2005 (p < 0.0001). The incidence of PIVH decreased across all weight ranges as well as at grades I/II and III/IV. Significant differences in antenatal corticosteroid use, gender (male), weight (< 1,000 g), hyaline membrane disease, mechanical ventilation, administration of surfactant, patent ductus arteriosus, and sepsis were found. Conclusion:The incidence of PIVH in very low birth weight infants declined significantly during the study period. J Pediatr (Rio J). 2011;87(6):505-11:Cerebral hemorrhage, premature birth, ultrasonography. ResumoObjetivo: Avaliar a incidência da hemorragia peri-intraventricular (HPIV) em recém-nascidos de muito baixo peso.Métodos: Foi realizado estudo de coorte prospectiva de recém-nascidos de muito baixo peso ao longo de 15 anos. Excluíram-se aqueles sem avaliação por ultrassonografia cerebral, com má-formação do sistema nervoso central ou falecidos antes de 24 horas de vida. Os exames foram realizados através da fontanela anterior, utilizando-se ecógrafo Aloka ® 620 e transdutor de 5 mHz, entre o primeiro e o terceiro dia de vida, e também no sétimo e no 28º dia de vida e/ou na alta hospitalar. A incidência foi analisada pelo teste de qui-quadrado de tendência ou pelo Cochran-Armitage test, e pelo modelo de regressão linear simples (curva de tendência logarítmica). Para avaliação dos possíveis fatores associados, analisaram-se dados obstétricos, perinatais e neonatais nos períodos de 1991/1994 e 2002/2005, com cálculo do teste de qui-quadrado / Fisher e do risco relativo. O nível de significância foi de 5%.Resultados: Nasceram 1.777 crianças de muito baixo peso, e 1.381 (77,7%) foram avaliadas. Dessas, 289 (20,9%) apresentaram HPIV. A distribuição anual mostrou queda na incidência, de 50,9% em 1991 para 11...

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Neonatal Intensive Care Unit Characteristics Affect the Incidence of Severe Intraventricular Hemorrhage

Abstract: The incidence of severe IVH is affected by NICU characteristics, suggesting important new strategies to reduce this important adverse outcome.

Cited by 93 publications

References 18 publications

Telemedicine Collaboration Improves Perinatal Regionalization and Lowers Statewide Infant Mortality

Telemedicine Collaboration Improves Perinatal Regionalization and Lowers Statewide Infant Mortality

Development and behaviour of 5-year-old very low birthweight infants

Incidence of periventricular/intraventricular hemorrhage in very low birth weight infants: a 15-year cohort study

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