Referral of mothers and infants for intensive care.

Blake, A M; Pollitzer, M J; Reynolds, Eor

doi:10.1136/bmj.2.6187.414

Cited by 31 publications

(6 citation statements)

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“…These included the obstetric factors present before delivery and extra information on ventilation and other complications after birth (table IV). We too had thought that antenatal transfer of our patients had improved their outcome; certainly the crude mortalities for the 10) 9 (1)(2)(3)(4)(5)(6)(7)(8)(9)(10) 7 (3)(4)(5)(6)(7)(8)(9) inborn, outborn, and in utero transfer groups suggested that infants transferred after birth had a higher mortality. Closer examination of 1-70) 07(02-10) 09(02-10) our study populations, however, showed that the outborn babies )-7-5) 7-2(6-7-7-4) 7-2(6-6-7-3) suypp were more immature and had a lower birth weight, and when these factors were taken into account there was no difference in the study populations.…”

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confidence: 94%

Effect of birthplace on infants with low birth weight.

Beverley¹,

Foote²,

Howel³

et al. 1986

BMJ

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From December 1983 to June 1985, 162 infants of less than 32 weeks' gestation or weighing less than 1500 g, or both, were cared for at the regional neonatal intensive care unit in Leeds. Of the 162, 64 (40%) were born in the unit because their mothers had received antenatal care there, 58 (36%) were born in another hospital and subsequently transferred, and 40 (25%) were transferred in utero because of potential complications. The overall mortalities for each group were 14%, 38%, and 18% respectively. These differences were significant, but when they were corrected for gestation, birth weight, and mode of delivery there was no difference in either the mortality or the incidence of intraventricular haemorrhage in the three study populations.Although there seem to be no distinct advantages of in utero transfer in terms of mortality and morbidity, there are other psychological and emotional advantages. We analysed the mortality and short term neurological outcome of 162 infants with very low birth weight who were either inborn, outborn, or transferred in utero to a large regional perinatal centre. Introduction

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confidence: 94%

Effect of birthplace on infants with low birth weight.

Beverley¹,

Foote²,

Howel³

et al. 1986

BMJ

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“…There is evidence to support antenatal transfer to a regional perinatal centre as a manoeuvre to improve neonatal survival (Lobb et al 1983;Blake et al 1979). However, increasing numbers of antenatal transfers present at least two problems.…”

Section: Discussionmentioning

confidence: 99%

Outcome of neonatal intensive care: obstetric implications for a regional service

Watkinson

McIntosh

1986

BJOG

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Summary. Data from 634 newborn babies with birthweights ≤2000 g admitted to the South West Thames Regional Neonatal Unit in St George's Hospital since its opening in 1980 were analysed. Only 271 (43%) of the pregnancies were booked there; 200 (32%) of the babies were transferred in utero and 162 (26%) after delivery. Weight‐specific neonatal survival rates, calculated after exclusion of lethal abnormalities showed that between 1001 and 1500 g, 79 (96%) of the 82 babies transferred in utero survived in 1981–1984, compared with only 57 (79%) of the 72 postnatal transfers (P<0.02). Under 1000 g, no such differences were found, possibly because paediatricians transferred only the fitter babies in this weight range. The birth of very‐low‐birthweight babies of short gestation in units unable to provide immediate resuscitation, adequate stabilization and full neonatal intensive care is a major risk factor for increased neonatal mortality. These findings support the role of regional perinatal centres as service units for antenatal transfer and neonatal intensive care, and as teaching centres.

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“…One is to increase staffing and facilities at a district level. Thus, if the approach to improving current practices in resuscitation and early stabilization at district hospitals is to be by There is evidence to support antenatal transfer to a regional perinatal centre as a manoeuvre to improve neonatal survival (Lobb et al 1983;Blake et al 1979). Wood et al (1984) have recently argued that 'better provision and training of district staff in immediate care at birth would probably be of more benefit in Wessex than the setting u p of a regional neonatal unit specialising in advanced neonatal intensive care.'…”

Section: Discussionmentioning

confidence: 99%

Outcome of neonatal intensive care: obstetric implications for a regional service

Watkinson¹,

McIntosh²

1986

BJOG

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Summary. Data from 634 newborn babies with birthweights ≤2000 g admitted to the South West Thames Regional Neonatal Unit in St George's Hospital since its opening in 1980 were analysed. Only 271 (43%) of the pregnancies were booked there; 200 (32%) of the babies were transferred in utero and 162 (26%) after delivery. Weight‐specific neonatal survival rates, calculated after exclusion of lethal abnormalities showed that between 1001 and 1500 g, 79 (96%) of the 82 babies transferred in utero survived in 1981–1984, compared with only 57 (79%) of the 72 postnatal transfers (P<0·02). Under 1000 g, no such differences were found, possibly because paediatricians transferred only the fitter babies in this weight range. The birth of very‐low‐birthweight babies of short gestation in units unable to provide immediate resuscitation, adequate stabilization and full neonatal intensive care is a major risk factor for increased neonatal mortality. These findings support the role of regional perinatal centres as service units for antenatal transfer and neonatal intensive care, and as teaching centres.

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Referral of mothers and infants for intensive care.

Abstract: Summary and conclusions During 1975-7, 96

Cited by 31 publications

References 1 publication

Effect of birthplace on infants with low birth weight.

Effect of birthplace on infants with low birth weight.

Outcome of neonatal intensive care: obstetric implications for a regional service

Outcome of neonatal intensive care: obstetric implications for a regional service

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