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The impact of volume and neonatal level of care on outcomes of moderate and late preterm infants.
- Source :
-
Journal of perinatology : official journal of the California Perinatal Association [J Perinatol] 2024 Oct; Vol. 44 (10), pp. 1409-1415. Date of Electronic Publication: 2024 Feb 27. - Publication Year :
- 2024
-
Abstract
- Objective: Evaluate the relationship of neonatal unit level of care (LOC) and volume with mortality or morbidity in moderate-late preterm (MLP) (32-36 weeks' gestation) infants.<br />Design: Retrospective cohort study of 650,865 inborn MLP infants in 4976 hospitals-years using 2003-2015 linked administrative data from 4 states. Exposure was combined neonatal LOC and MLP annual volume. The primary outcome was death or morbidity (respiratory distress syndrome, severe intraventricular hemorrhage, necrotizing enterocolitis, sepsis, infection, pneumothorax, extreme length of stay) with components as secondary outcomes. Poisson regression models adjusted for patient characteristics with a random effect for unit were used.<br />Results: In adjusted models, high-volume level 2 units had a lower risk of the primary outcome compared to low-volume level 3 units (aIRR 0.90 [95% CI 0.83-0.98] vs. aIRR 1.13 [95% CI 1.03-1.24], pā<ā0.001) CONCLUSION: MLP infants had improved outcomes in high-volume level 2 units compared to low-volume level 3 units in adjusted analysis.<br /> (© 2024. The Author(s), under exclusive licence to Springer Nature America, Inc.)
- Subjects :
- Humans
Infant, Newborn
Retrospective Studies
Female
Male
Intensive Care Units, Neonatal
Hospitals, Low-Volume statistics & numerical data
Gestational Age
Length of Stay statistics & numerical data
United States
Infant Mortality
Infant
Respiratory Distress Syndrome, Newborn therapy
Infant, Premature
Hospitals, High-Volume
Infant, Premature, Diseases therapy
Infant, Premature, Diseases mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1476-5543
- Volume :
- 44
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Journal of perinatology : official journal of the California Perinatal Association
- Publication Type :
- Academic Journal
- Accession number :
- 38413758
- Full Text :
- https://doi.org/10.1038/s41372-024-01901-x