التفاصيل البيبلوغرافية
| العنوان: |
Obstetrical volume and early neonatal mortality in preterm infants. |
| المؤلفون: |
Dorothee Bartels, Paul Wenzlaff, Christian Poets |
| المصدر: |
European Journal of Epidemiology; Nov2007, Vol. 22 Issue 11, p791-798, 8p |
| مصطلحات موضوعية: |
PREMATURE infants, NEONATAL mortality, PERINATAL care, MATERNITY nursing |
| مستخلص: |
Abstract  Objective Regionalised perinatal care with antenatal transfer of high risk pregnancies to Level III centres is beneficial. However, levels of care are usually not linked to caseload requirements, which remain a point for discussion. We aimed to investigate the impact of annual delivery volume on early neonatal mortality among very preterm births. Methods All neonates with gestational age 24â30 weeks, born 1991â1999 in Lower Saxony were included into this population-based cohort study (n = 5,083). Large units were defined as caring for more than 1,000 deliveries/year, large NICUs as those with at least 36 annual very low birthweight (Results Within the first week of life, 20.6% of all neonates deceased; 10.2% were stillbirths, 3.7% died in the delivery unit, and 6.7% in the NICU. The crude OR for early neonatal mortality after having been delivered in a small delivery unit (excluding stillbirths) was 1.36 (95%CI 1.04â1.78; adj. OR 1.16 (0.82â1.63)). It increased to 1.96 (1.54â2.48; adj. OR 1.21 (0.86â1.70)) after the inclusion of stillbirths. Conclusion This study has shown a slight, but non-significant association between obstetrical volume and early neonatal mortality. In future studies the impact of caseload on outcome may become more evident when referring to high-risk patients instead of to the overall number of deliveries. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
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