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

Watkinson, Michael; McIntosh, Neil

doi:10.1111/j.1471-0528.1986.tb08056.x

Cited by 4 publications

(2 citation statements)

References 8 publications

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“…The other three studies did not find a significant difference. [31][32][33] Of the four birth weight studies investigating this outcome, three found a significant difference (in neonatal mortality, 44 predischarge mortality 38 and survival up to 2 years of age 42 ).…”

Section: Discussionmentioning

confidence: 97%

The impact of level of neonatal care provision on outcomes for preterm babies born between 27 and 31 weeks of gestation, or with a birth weight between 1000 and 1500 g: a review of the literature

Ismail

Boyle

Pillay

2020

bmjpo

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ObjectiveThere is evidence that birth and care in a maternity service associated with a neonatal intensive care unit (NICU) is associated with improved survival in preterm babies born at <27 weeks of gestation. We conducted a systematic review to address whether similar gains manifested in babies born between 27+0 and 31+6 weeks (hereafter 27 and 31 weeks) of gestation, or in those with a birth weight between 1000 and 1500 g.MethodsWe searched Embase, Medline and CINAHL databases for studies comparing outcomes for babies born between 27 and 31 weeks or between 1000 and 1500 g birth weight, based on designation of the neonatal unit where the baby was born or subsequently cared for (NICU vs non-NICU setting). A modified QUIPS (QUality In Prognostic Studies) tool was used to assess quality.ResultsNine studies compared outcomes for babies born between 27 and 31 weeks of gestation and 11 studies compared outcomes for babies born between 1000 and 1500 g birth weight. Heterogeneity in comparator groups, birth locations, gestational age ranges, timescale for mortality reporting, and description of morbidities facilitated a narrative review as opposed to a meta-analysis.ConclusionDue to paucity of evidence, significant heterogeneity and potential for bias, we were not able to answer our question—does place of birth or care affect outcomes for babies born between 27 and 31 weeks? This supports the need for large-scale research to investigate place of birth and care for babies born in this gestational age range.

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Section: Discussionmentioning

confidence: 97%

The impact of level of neonatal care provision on outcomes for preterm babies born between 27 and 31 weeks of gestation, or with a birth weight between 1000 and 1500 g: a review of the literature

Ismail

Boyle

Pillay

2020

bmjpo

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“…A recent survey of 375 German departments of obstetrics revealed that only half of the obstetricians use glucocorticoids before 28 weeks of gestation [16]. With the progress of modern perinatal medicine, infants with a birthweight between 1000 and 1500 g and without malformations now have a 96% chance of survival [41]. Smaller infants, however, are still at risk of severe RDS, and still have a considerable mortality and morbidity despite modern ventilatory techniques and surfactant administration: presently, survival rates of 16, 53, 63, and 72% are reported for infants born at 24, 25, 26, and 27 weeks of gestation, respectively [14].…”

Section: Introductionmentioning

confidence: 99%

Accelerated lung maturation following maternal steroid treatment in infants born before 30 weeks gestation

Kattner¹,

Metze²,

E³

et al. 1992

Jpme

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A meta-analysis was performed of 9 controlled trials of maternal beta-/dexamethasone treatment in which the incidence of RDS in infants born before 30 weeks gestation was reported. A significant decrease could be shown in 250 immature infants. The number of cases was to small for analysis of lower gestational ages or for the demonstration of a reduction in mortality. In a separate study of 135 infants born before 30 weeks gestation tracheal aspirate phospholipid analysis was performed using thin layer chromatography. 64 of them had been exposed prenatally to steroids. Significantly more of these infants had a mature L/S ratio > or = 2.7 (p < 0.02) and prenatal glucocorticoid treatment was associated with a markedly increased survival rate (odds ratio 2.4, p < 0.02). We conclude from the meta-analysis of the literature and from the findings of our study, that accelerated lung maturation follows prenatal steroid treatment with a reduction in RDS-incidence even in very immature fetuses. Consequently it would be appropriate to administer glucocorticoids combined with tocolysis since this has been shown to be beneficial for those women threatening to deliver prematurely at less than 30 weeks gestation.

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Levy

2000

Journal de Pédiatrie et de Puériculture

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

Cited by 4 publications

References 8 publications

The impact of level of neonatal care provision on outcomes for preterm babies born between 27 and 31 weeks of gestation, or with a birth weight between 1000 and 1500 g: a review of the literature

The impact of level of neonatal care provision on outcomes for preterm babies born between 27 and 31 weeks of gestation, or with a birth weight between 1000 and 1500 g: a review of the literature

Accelerated lung maturation following maternal steroid treatment in infants born before 30 weeks gestation

Prise en charge, critères d'extraction, mode d'accouchement

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