Improved outcome of preterm infants when delivered in tertiary care centers

Abstract

Outborn infants were less mature and more ill than inborn infants at NICU admission. However, even after adjustment for perinatal risks and admission illness severity, inborn infants had better outcomes than outborn infants. Our results support in-utero transfer of high-risk pregnancies to a tertiary level facility.

Obstetrical volume and early neonatal mortality in preterm infants

“…In contrast to other studies [31], inborn status did not show a protective effect in the first modelling process (n = 4,566). Again, correlation with hospital volume might be a possible explanation: In small obstetrical units 53% of infants were inborn, in large units it was only 46%.…”

An illness severity score and neonatal mortality in retrieved neonates

“…Only a minority of the infants were VLBW, the result of practicing an aggressive policy of in-utero transfer of high-risk patients. Such a policy, rather than ex-utero transfer, has been shown to be associated with a lower neonatal mortality and morbidity [1,6]. The greatest change in the MCRIB score was from the time of first call to the time of first look by the retrieval team.…”

Review of Respiratory Management of Extremely Premature Neonates During Transport

“…1 Birth outside a tertiary perinatal center increases the risk even further. [2][3][4][5][6][7] Potential reasons include incomplete antenatal corticosteroid coverage, attendance at delivery of staff members relatively inexperienced in neonatal resuscitation, delay in surfactant administration for respiratory distress syndrome, and unintentional hypothermia.…”