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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

journal contribution
posted on 27.03.2020, 09:53 by Abdul Qader Tahir Ismail, Elaine M Boyle, Thillagavathie Pillay
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.

Funding

This work is supported by the NIHR HS&DR Stream, Project number 15/70/104, and by the Royal Wolverhampton NHS Trust, Protocol number 2016NEO87. AQTI is undertaking a PhD with the University of Leicester, with funding from the OptiPrem project.

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Citation

Ismail AQT, Boyle EM, Pillay T On behalf of The OptiPrem Study GroupThe 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 literatureBMJ Paediatrics Open 2020;4:e000583. doi: 10.1136/bmjpo-2019-000583

Version

VoR (Version of Record)

Published in

BMJ Paediatrics Open

Volume

4

Issue

1

Pagination

e000583 - e000583

Publisher

BMJ

eissn

2399-9772

Acceptance date

31/01/2020

Copyright date

2020

Available date

18/03/2020

Publisher version

https://bmjpaedsopen.bmj.com/content/4/1/e000583

Language

en

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