Arch Dis Child Fetal Neonatal Ed-2015-Boyle-archdischild-2014-307347.pdf (358.1 kB)
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Neonatal outcomes and delivery of care for infants born late preterm or moderately preterm: A prospective population-based study

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journal contribution
posted on 08.04.2015, 09:58 by Elaine M. Boyle, Samantha Johnson, Bradley Manktelow, Sarah E. Seaton, Elizabeth S. Draper, Lucy K Smith, Jon Dorling, N. Marlow, S. Petrou, D. J. Field
Objective: To describe neonatal outcomes and explore variation in delivery of care for infants born late (34-36 weeks) and moderately (32-33 weeks) preterm (LMPT). Design/setting: Prospective population-based study comprising births in four major maternity centres, one midwifery-led unit and at home between September 2009 and December 2010. Data were obtained from maternal and neonatal records. Participants: All LMPT infants were eligible. A random sample of term-born infants (≥37 weeks) acted as controls. Outcome measures: Neonatal unit admission, respiratory and nutritional support, neonatal morbidities, investigations, length of stay and postnatal ward care were measured. Differences between centres were explored. Results: 1146 (83%) LMPT and 1258 (79% of eligible) term-born infants were recruited. LMPT infants were significantly more likely to receive resuscitation at birth (17.5% v. 7.4%), respiratory (11.8% v. 0.9%) and nutritional support (3.5% v. 0.3%) and were less likely to be fed breast milk (64.2% v. 72.2%) than term infants. For all interventions and morbidities, a gradient of increasing risk with decreasing gestation was evident. Although 60% of late preterm infants were never admitted to a neonatal unit, 83% required medical input on postnatal wards. Clinical management differed significantly between services. Conclusion: LMPT infants place high demands on specialist neonatal services. A substantial amount of previously unreported specialist input is provided in postnatal wards, beyond normal newborn care. Appropriate expertise and planning of early care 5 is essential if such infants are managed away from specialised neonatal settings. Further research is required to clarify optimal and cost-effective postnatal management for LMPT babies.

Funding

National Institute for Health Research Programme Grants for Applied Research.

History

Citation

Archives of Disease in Childhood: Fetal and Neonatal Edition 1 April 2015;0:F1–F7

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Health Sciences

Version

VoR (Version of Record)

Published in

Archives of Disease in Childhood: Fetal and Neonatal Edition 1 April 2015;0:F1–F7

Publisher

BMJ Publishing Group

issn

1359-2998

Available date

08/04/2015

Publisher version

http://fn.bmj.com/content/early/2015/04/01/archdischild-2014-307347.full

Language

en

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