Antenatal Transfers and Bronchopulmonary Dysplasia Incidence

Hobar et al attempted to compare weight-specific neonatal mortality rates among 11 neonatal intensive care units. All patients were inborn. Finding a statistically significant variability of outcome among these neonatal intensive care units, after the effects of birth weight, gender, and race were considered and accounted for, the authors wondered whether other population variables might explain the differences in outcome. One source of variability that would alter population risk among the neonatal intensive care units is patient selection by antenatal transfers into a referral center for delivery.

Download Full-text

Device-associated pneumonia of very low birth weight infants in Polish Neonatal Intensive Care Units

Advances in Medical Sciences ◽

10.1016/j.advms.2015.09.002 ◽

2016 ◽

Vol 61 (1) ◽

pp. 90-95 ◽

Cited By ~ 4

Author(s):

Jadwiga Wójkowska-Mach ◽

T. Allen Merritt ◽

Maria Borszewska-Kornacka ◽

Joanna Domańska ◽

Ewa Gulczyńska ◽

...

Keyword(s):

Intensive Care ◽

Birth Weight ◽

Low Birth Weight ◽

Intensive Care Units ◽

Neonatal Intensive Care ◽

Very Low Birth Weight ◽

Neonatal Intensive Care Units ◽

Low Birth Weight Infants

Download Full-text

Score for Neonatal Acute Physiology: Validation in Three Kaiser Permanente Neonatal Intensive Care Units

PEDIATRICS ◽

10.1542/peds.96.5.918 ◽

1995 ◽

Vol 96 (5) ◽

pp. 918-922 ◽

Cited By ~ 6

Author(s):

Gabriel J. Escobar ◽

Allen Fischer ◽

De Kun Li ◽

Robert Kremers ◽

Mary Anne Armstrong

Keyword(s):

Intensive Care ◽

Birth Weight ◽

Hospital Mortality ◽

Intensive Care Units ◽

Neonatal Intensive Care ◽

Severity Of Illness ◽

Predictive Ability ◽

Neonatal Intensive Care Units ◽

Total Hospital ◽

Total Hospital Stay

Background. Measurement of the severity of illness is a research area of growing importance in neonatal intensive care. Most severity of illness scales have been developed in tertiary care settings. Their applicability in community neonatal intensive care units has not been tested. Objectives. Our goal was to assess the operational characteristics of the score for neonatal acute physiology (SNAP): the relationship to birth weight, the length of total hospital stay, and in-hospital mortality. Methods. We assigned SNAP scores prospectively to all inborn admissions at three community neonatal intensive care units during an 11-month period. Data on other neonatal predictors (eg, birth weight and the presence of congenital heart disease) were also collected. We measured in-hospital mortality, the experience of interhospital transport to a higher level of care, and total hospital stay. Results. We found that the SNAP's relationship to birth weight was similar to previous reports. The SNAP's perinatal extension is a reliable predictor of newborn in-hospital mortality, with an area under the receiver operator characteristic curve of 0.95. The SNAP is also a good predictor of total hospital length of stay, whether by itself (by which it can explain 31% of the total stay) or in combination with other variables. Its predictive ability is better among infants of low birth weight (<2500 g) than among those of normal birth weight (≥2500 g). The SNAP's predictive power was most limited among infants admitted to rule out sepsis. The predictive ability of a model containing birth weight, the SNAP, and transport status was not improved by the inclusion of two major diagnostic categories, the presence of congenital heart disease or complex illness. Conclusion. Although it has definite limitations among infants who weigh 2500 g or more, the SNAP is a potent tool for outcomes research. Modification of some of its parameters could result in a multifunctional scale suitable for use with all birth weights.

Download Full-text

Cause and Predictors of Neonatal Mortality among Neonates Admitted to the Neonatal Intensive Care Units of Public Hospitals in Eastern Ethiopia: Facilities Based Prospective Follow-up Study

10.21203/rs.2.20703/v2 ◽

2020 ◽

Author(s):

Assefa Desalew ◽

Yitagesu Sintayehu ◽

Nardos Teferi ◽

Firehiwot Amare ◽

Bifitu Geda ◽

...

Keyword(s):

Intensive Care ◽

Neonatal Mortality ◽

Intensive Care Units ◽

Neonatal Death ◽

Neonatal Intensive Care ◽

Causes Of Death ◽

Public Hospitals ◽

Neonatal Intensive Care Units ◽

Eastern Ethiopia

Abstract Background The first month is the most crucial period for child survival. Neonatal mortality continues to remain high with little improvement over the years in Sub-Saharan Africa including Ethiopia. This region shows the least progress to reducing neonatal mortality and it continues to be a significant public health issue. The facilities-based causes and predictors of neonatal death in the neonatal intensive care unit are not well documented in this study setting. Hence, the aim of this study was to determine the causes and predictors of neonatal mortality among infants admitted to the neonatal intensive care units in Eastern Ethiopia. Methods Facilities-based prospective follow-up study was conducted among neonates admitted to the neonatal intensive care units of public hospitals in Eastern Ethiopia from November to December 2018. Data were collected using a pre-tested, structured questionnaire and a follow-up checklist. The main outcomes and causes of death were set by pediatricians and medical residents. Epi-Data 3.1 and Statistical Package for Social Sciences Version 25 software were used for data entry and analysis respectively. Multivariable logistic regression was used to find out the predictors of facilities-based neonatal mortality. Results The proportion of facilities-based neonatal mortality was 20%(95% CI: 16.7-23.8%) The causes of death were complications of preterm birth 28.58%, birth asphyxia 22.45%, infection 18.36%, meconium aspiration syndrome 9.18%, respiratory distress syndrome 7.14% and congenital malformation 4.08%. Low birth weight, preterm births, length of stay in NICU, low 5 minute Apgar score, hyperthermia and initiation of feeding were predictors of neonatal death among infants admitted to the neonatal intensive care units in public hospitals, Eastern Ethiopia. Conclusion The proportion of facilities-based neonatal deaths was unacceptably high. The main causes of death were preventable and treatable. Hence, improving timing and quality of ANC is essential for early detection, anticipating high-risk newborns and timely interventions. Furthermore, early initiation of feeding and a better referral linkage to tertiary facilities could lead to a reduction of neonatal death in this setting.

Download Full-text

Neonatal Mortality Statistics

PEDIATRICS ◽

10.1542/peds.74.1.168 ◽

1984 ◽

Vol 74 (1) ◽

pp. 168-168

Author(s):

SAM SHAPIRO ◽

MARIE C. MCCORMICK ◽

BARBARA STARFIELD

Keyword(s):

Intensive Care ◽

Neonatal Mortality ◽

Intensive Care Units ◽

Neonatal Intensive Care ◽

Neonatal Intensive Care Units ◽

Mortality Statistics ◽

Total Reduction ◽

Social Environmental

In Reply.— Sepkowitz uses data in our paper to question the influence of neonatal intensive care units (NICUs) during the 1970s in reducing neonatal mortality. Part of the argument is based on the calculation that about 43% of the total reduction in such deaths between 1976 and 1978 to 1979 occurred among infants weighing more than 2,500 g at birth, a group for which "neonatal intensive care ... would seldom be necessary ..." Certainly there are many factors—social, environmental, and medical, including improved care in the antenatal and intrapartum periods—that have affected the reduction in neonatal mortality.

Download Full-text

Morbidity and Mortality Among Low Birth Weight Infants Exposed to an Intravenous Vitamin E Product, E-Ferol

PEDIATRICS ◽

10.1542/peds.83.2.244 ◽

1989 ◽

Vol 83 (2) ◽

pp. 244-249

Author(s):

Janet B. Arrowsmith ◽

Gerald A. Faich ◽

Dianne K. Tomita ◽

Joel N. Kuritsky ◽

Franz W. Rosa

Keyword(s):

Intensive Care ◽

Birth Weight ◽

Vitamin E ◽

Low Birth Weight ◽

Intensive Care Units ◽

Neonatal Intensive Care ◽

Morbidity And Mortality ◽

Neonatal Intensive Care Units ◽

Low Birth Weight Infants ◽

Intravenous Vitamin

In April 1984, the US FDA was notified of an unusual clinical syndrome consisting of ascites, liver and renal failure, thrombocytopenia, and death among low birth weight infants exposed to an intravenous vitamin E preparation, E-Ferol. The product, which had not been tested for safety prior to marketing, was voluntarily withdrawn from the market in early April. To further investigate the reported associations, the FDA conducted a retrospective cohort study among seven neonatal intensive care units where the product had been used. Standardized abstraction forms were completed for infants admitted to a unit between Nov 1, 1983, and April 30, 1984. Included in the study were 379 infants weighing 2,000 g or less and surviving at least two days; 148 (39%) had been exposed to E-Ferol. Compared with the unexposed infants, the exposed infants were more likely to die and to have ascites, hepatomegaly, thrombocytopenia, and a combination of clinical events similar to the syndrome initially reported. We conclude that the use of E-Ferol in these neonatal intensive care units was associated with increased morbidity and mortality among exposed infants.

Download Full-text

The effect of thermoregulation quality improvement initiatives on the admission temperature of premature/very low birth‐weight infants in neonatal intensive care units: A systematic review

Journal for Specialists in Pediatric Nursing ◽

10.1111/jspn.12286 ◽

2020 ◽

Vol 25 (2) ◽

Author(s):

Denise Donnellan ◽

Zena Moore ◽

Declan Patton ◽

Tom O'Connor ◽

Linda Nugent

Keyword(s):

Systematic Review ◽

Intensive Care ◽

Quality Improvement ◽

Birth Weight ◽

Low Birth Weight ◽

Intensive Care Units ◽

Neonatal Intensive Care ◽

Very Low Birth Weight ◽

Neonatal Intensive Care Units ◽

Low Birth Weight Infants

Download Full-text

Cause and predictors of neonatal mortality among neonates admitted to neonatal intensive care units of public hospitals in eastern Ethiopia: a facility-based prospective follow-up study

BMC Pediatrics ◽

10.1186/s12887-020-02051-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Assefa Desalew ◽

Yitagesu Sintayehu ◽

Nardos Teferi ◽

Firehiwot Amare ◽

Bifitu Geda ◽

...

Keyword(s):

Intensive Care ◽

Neonatal Mortality ◽

Intensive Care Units ◽

Neonatal Intensive Care ◽

Public Hospitals ◽

Neonatal Intensive Care Units ◽

Eastern Ethiopia ◽

Follow Up Study

Download Full-text

Incidence Density Rate of Neonatal Mortality and Predictors in Sub-Saharan Africa: A Systematic Review and Meta-Analysis

International Journal of Pediatrics ◽

10.1155/2020/3894026 ◽

2020 ◽

Vol 2020 ◽

pp. 1-14

Author(s):

Zebenay Workneh Bitew ◽

Ayinalem Alemu ◽

Ermias Getaneh Ayele ◽

Desalegn Abebaw Jember ◽

Michael Tamene Haile ◽

...

Keyword(s):

Intensive Care ◽

Neonatal Mortality ◽

Intensive Care Units ◽

Neonatal Intensive Care ◽

Sub Saharan Africa ◽

Incidence Density ◽

Neonatal Intensive Care Units ◽

Sub Saharan ◽

Incidence Density Rate ◽

Density Rate

Background. Neonatal mortality in Sub-Saharan countries is remarkably high. Though there are inconsistent studies about the incidence density rate of neonatal mortalities (IDR) and predictors in Sub-Saharan Africa, they are inconclusive to policymakers and program planners. In this study, the IDR of neonatal mortalities and predictors was determined. Methods. Electronic databases (Web of Science, PubMed, EMBASE (Elsevier), Scopus, CINAHL (EBSCOhost), World Cat, Google Scholar, and Google) were explored. 20 out of 818 studies were included in this study. The IDRs and predictors of neonatal mortality were computed from studies conducted in survival analysis. Fixed and random effect models were used to compute pooled estimates. Subgroup and sensitivity analyses were performed. Results. Neonates were followed for a total of 1,095,611 neonate-days; 67142 neonate-days for neonates treated in neonatal intensive care units and 1,028,469 neonate-days for community-based studies. The IDRs of neonatal mortalities in neonatal intensive care units and in the community were 24.53 and 1.21 per 1000 person-days, respectively. The IDRs of early and late neonatal mortalities neonatal intensive care units were 22.51 and 5.09 per 1000 neonate-days, respectively. Likewise, the IDRs of early and late neonatal mortalities in the community were 0.85 and 0.31, respectively. Not initiating breastfeeding within one hour, multiple births, rural residence, maternal illness, low Apgar score, being preterm, sepsis, asphyxia, and respiratory distress syndrome were independent predictors of time to neonatal mortality in neonatal intensive care units and male gender, perceived small size, multiple births, and ANC were predictors of neonatal mortality in the community. Conclusion. The incidence density rate of neonatal mortality in Sub-Saharan Africa is significantly high. Multiple factors (neonatal and maternal) were found to be independent predictors. Strategies must be designed to address these predictors, and prospective studies could reveal other possible factors of neonatal mortalities.

Download Full-text

Holding the Very Low Birth Weight Infant: Skin-to-Skin Techniques

Neonatal Network The Journal of Neonatal Nursing ◽

10.1891/0730-0832.24.1.7 ◽

2005 ◽

Vol 24 (1) ◽

pp. 7-14 ◽

Cited By ~ 8

Author(s):

Theresa Kledzik

Keyword(s):

Intensive Care ◽

Birth Weight ◽

Low Birth Weight ◽

Intensive Care Units ◽

Preterm Infants ◽

Neonatal Intensive Care ◽

Very Low Birth Weight ◽

Neonatal Intensive Care Units ◽

Low Birth Weight Infant ◽

Skin To Skin

Skin-to-skin holding has been reported as a valuable intervention for preterm infants for over a decade. However, many neonatal intensive care units are not practicing this therapy and cite lack of protocols and techniques as a barrier. This article describes in detail the nursing considerations and techniques involved to successfully implement skin-to-skin holding for very low birth weight, technology-dependent infants. NICU protocols can be derived from this article.

Download Full-text