More than Just a Fad: Building and Maintaining a Small Baby Program

2021 ◽  
Vol 40 (4) ◽  
pp. 224-232
Author(s):  
Ching Ching Tay ◽  
Serena de la O ◽  
Summer Finn ◽  
James Fritzell
Keyword(s):  
At Risk ◽  
Birth Weight ◽  
Survival Rate ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Continuous Improvement ◽  
Extremely Low Birth Weight ◽  
Change Model ◽  
Model Framework

Survival rate for preterm infants has improved significantly in the last decade because of advancements in care provided by NICUs. Yet, a large proportion of extremely low birth weight (ELBW) infants continue to be at risk of being discharged home from NICUs with long-term co-morbidities. Several centers have introduced and described the concept of a focused program on the care of micro-preemies and demonstrated improved processes as well as outcomes utilizing a continuous improvement approach with adoption of standardized guidelines, checklists, and shared team values. The journey and effort that it takes to develop and sustain such a program have been described less. This article discusses the process of building a Small Baby Program using a change model framework, how the organization and staff bought into the concept, as well as the accomplishments and challenges experienced during the last 3 years as the program continues to evolve and grow.

scholarly journals Az extrém kis születési súlyú koraszülöttek fejlődésének követése az óvodáskor végéig a perinatalis szövődmények tükrében

2018 ◽  
Vol 159 (41) ◽  
pp. 1672-1679
Author(s):  
Anett Nagy ◽  
Anna Mária Beke ◽  
Renáta Cserjési ◽  
Rózsa Gráf ◽  
Magda Kalmár
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Developmental Outcomes ◽  
Extremely Low Birth Weight ◽  
Psychomotor Development ◽  
Preterm Children ◽  
Extremely Preterm ◽  
The Mean

Abstract: Introduction: Owing to the rapid progress of the medical science and technology, the chances of survival of the extremely low birth weight (<1000 g) preterm babies have dramatically improved. Nevertheless, the research findings on their long-term developmental outcome are inconsistent. Aim: Our study has attempted to contribute to the understanding of the developmental mechanisms in the extremely low birth weight preterm infants and to the prediction of the developmental outcomes taking into account of the risk factors of development. Method: 34 preterm children who were free of any major central nervous system injury were followed up from one to 5–6 years of age. The psychomotor development of the infants was assessed at 1 and 2 years of age and, at 5–6 years of age, intelligence tests were administered to the children. Perinatal and environmental factors were included in the data analysis. Results: The extremely low birth weight preterm children as a group displayed no developmental delay at any of the measurement points. The mean developmental quotients were 98.6 and 106.6 at ages 1 and 2 years, respectively. At 5–6 years of age, the mean verbal IQ was 101.4, while the mean performance IQ was 92.9. Behind the group means there was a wide range of individual variations. The most powerful contributors to the developmental outcomes were birth weight, bronchopulmonary dysplasia, intra-uterine growth retardation, gender, and maternal education. The girls had a significant advantage over the boys in language development. Verbal intelligence was hampered by intracranial hemorrhage, while intrauterine growth restriction had a similar effect on the performance IQ. Conclusions: Our results suggest that even the extremely preterm infants may have rather good chances of satisfactory mental development. However, the individual developmental prospects are influenced by a great number of domain-specific risk- and protective factors. Although at a group-level, infant psychomotor development is a significant predictor of later intelligence quotient, the rate of development may change at any age. The phenomenon of “moving risk” underscores the importance of the long-term follow-up of preterm infants. Orv Hetil. 2018; 159(41): 1672–1679.

Is intravenous fish oil associated with the neurodevelopment of extremely low birth weight preterm infants on parenteral nutrition?

2021 ◽  
Author(s):  
Chiara Biagetti ◽  
Alessio Correani ◽  
Rita D’Ascenzo ◽  
Enrica Ferretti ◽  
Cecilia Proietti ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Parenteral Nutrition ◽  
Fish Oil ◽  
Preterm Infants ◽  
Extremely Low Birth Weight

scholarly journals IMPACT OF MULTIPLE BIRTHS ON THE OUTCOME IN EXTREMELY LOW BIRTH WEIGHT NEWBORNS

2021 ◽  
Vol 27 (3) ◽  
pp. 3985-3991
Author(s):  
Victoria Atanasova ◽  
◽  
Petar Ivanov ◽  
Elitsa Gyokova ◽  
Desislava Georgieva ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Assisted Reproductive Technologies ◽  
Ductus Arteriosus ◽  
Intraventricular Haemorrhage ◽  
Reproductive Technologies ◽  
University Hospital ◽  
Extremely Low Birth Weight ◽  
Gastrointestinal Problems

Objective: To evaluate the outcome of the extremely low birth weight newborns (ELBWNs) from single and twin pregnancies. Material and methods: The study lasts from 2005 to 2017 and includes all life born ELBWNs treated in University Hospital, Pleven, Bulgaria. Patients' groups: singletons (1) and twins (2); twins conceived naturally(2.1) and after assisted reproductive technologies – ART(2.2). Results: One hundred and eighty two (182) ELBWNs are examined, 65 (35.7%) of them are twins. The twins, compared to singletons, are significantly more often conceived by ART (47.7 vs 4.3%, p<0.001) and significantly more rarely infected prenatally (18 vs 41%, p 0.002). The survival rate is 51.3% for singletons and 56.6% for twins, NS. Survived twins (n 37) achieve later their optimal nutritive tolerance (30±11 vs 25±10 days, p 0.046), require more blood transfusions (3.6±1.9 vs 2.6±1.8 per patient, p 0.009) and longer mechanical ventilation (16±15 vs 9±12 days, p 0.03) than survival singletons (n 60). The twins suffer more often from intraventricular haemorrhage (46 vs 18%, p 0.004), patent ductus arteriosus (35 vs 15%, p 0.02) and long-term complications (51 vs 30%, p 0.04) than singletons. ART-twins (n 31)compared to the subgroup 2.1 (n 34) are more frequently intubated in the delivery room (81 vs. 50%, p 0.01)but suffer less frequently from nosocomial infections (53 vs. 85%, p 0.03). Conclusions: According to our data, ELBW-twins frequently suffer from respiratory, haemorrhagic, and gastrointestinal problems than ELBW-singletons, resulting in more long-term complications. Our study proves that ART does not influence the outcome in multiples.

Incidence, Severity, and Timing of Subependymal and Intraventricular Hemorrhages in Preterm Infants Born in a Perinatal Unit as Detected by Serial Real-Time Ultrasound

PEDIATRICS ◽  
1983 ◽  
Vol 71 (4) ◽  
pp. 541-546 ◽  
Author(s):  
Tzipora Dolfin ◽  
Martin B. Skidmore ◽  
Katherine W. Fong ◽  
Elizabeth M. Hoskins ◽  
Andrew T. Shennan
Keyword(s):  
At Risk ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Real Time ◽  
Preterm Infants ◽  
Intraventricular Hemorrhage ◽  
Study Group ◽  
Low Birth Weight Infants ◽  
Grade Iii

Real-time ultrasound scans were performed on 66 low-birth-weight infants within the first six hours of life (mean, two hours), and then at 12, 24, 48, and 72 hours, and thereafter at weekly intervals. All of the infants were born in a perinatal unit. The incidence of intraventricular hemorrhage and subependymal hemorrhage was 31%. Eight of 20 infants had small hemorrhages (Papile, grades I and II); seven infants sustained grade III hemorrhages, and five infants sustained grade Iv hemorrhages. All hemorrhages occurred in the first 72 hours of life; 25% were diagnosed with the first scan (ie, within the first six hours of life). The infants especially at risk were those less than 29 weeks's gestation. Five infants developed progressive posthemorrhagic ventriculomegaly that subsided spontaneously by age 8 weeks. The mortality in the study group was only 4.5%.

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