Mortality and Morbidities according to Time of Birth in Extremely Low Birth Weight Infants.
After-Hours Care
Cerebral Intraventricular Hemorrhage
/ epidemiology
Databases, Factual
Enterocolitis, Necrotizing
/ epidemiology
Female
Gestational Age
Humans
Infant
Infant Mortality
Infant, Extremely Low Birth Weight
Infant, Newborn
Infant, Premature, Diseases
/ epidemiology
Intensive Care Units, Neonatal
Logistic Models
Male
Morbidity
Odds Ratio
Quality of Health Care
Republic of Korea
Time Factors
After-hours Care
Neonatal Intensive Care
Neonatal Mortality
Preterm Infants
Quality of Health Care
Journal
Journal of Korean medical science
ISSN: 1598-6357
Titre abrégé: J Korean Med Sci
Pays: Korea (South)
ID NLM: 8703518
Informations de publication
Date de publication:
05 Apr 2021
05 Apr 2021
Historique:
received:
10
10
2020
accepted:
14
01
2021
entrez:
6
4
2021
pubmed:
7
4
2021
medline:
21
10
2021
Statut:
epublish
Résumé
Although the overall quality of high-risk neonatal care has improved recently, there is still concern about a difference in the quality of care when comparing off-hour births and regular-hour births. Moreover, there are no data in Korea regarding the impact of time of birth on mortality and morbidities in preterm infants. A total of 3,220 infants weighing < 1,000 g and born at 23-34 weeks in 2013-2017 were analyzed based on the Korean Neonatal Network data. Mortality and major morbidities were analyzed using logistic regression according to time of birth during off-hours (nighttime, weekend, and holiday) and regular hours. The institutes were sub-grouped into hospital group I and hospital group II based on the neonatal intensive care unit (NICU) care level defined by the mortality rates of < 50% and ≥ 50%, respectively, in infants born at 23-24 weeks' gestation. The number of births during regular hours and off-hours was similar. In the total population and hospital group I, off-hour births were not associated with increased neonatal mortality and morbidities. However, in hospital group II, increased early mortality was found in the off-hour births when compared to regular-hour births. Efforts to improve the overall quality of NICU are required to lower the early mortality rate in off-hour births. Also, other sensitive indexes for the evaluation of quality of NICU care should be further studied.
Sections du résumé
BACKGROUND
BACKGROUND
Although the overall quality of high-risk neonatal care has improved recently, there is still concern about a difference in the quality of care when comparing off-hour births and regular-hour births. Moreover, there are no data in Korea regarding the impact of time of birth on mortality and morbidities in preterm infants.
METHODS
METHODS
A total of 3,220 infants weighing < 1,000 g and born at 23-34 weeks in 2013-2017 were analyzed based on the Korean Neonatal Network data. Mortality and major morbidities were analyzed using logistic regression according to time of birth during off-hours (nighttime, weekend, and holiday) and regular hours. The institutes were sub-grouped into hospital group I and hospital group II based on the neonatal intensive care unit (NICU) care level defined by the mortality rates of < 50% and ≥ 50%, respectively, in infants born at 23-24 weeks' gestation.
RESULTS
RESULTS
The number of births during regular hours and off-hours was similar. In the total population and hospital group I, off-hour births were not associated with increased neonatal mortality and morbidities. However, in hospital group II, increased early mortality was found in the off-hour births when compared to regular-hour births.
CONCLUSION
CONCLUSIONS
Efforts to improve the overall quality of NICU are required to lower the early mortality rate in off-hour births. Also, other sensitive indexes for the evaluation of quality of NICU care should be further studied.
Identifiants
pubmed: 33821593
pii: 36.e86
doi: 10.3346/jkms.2021.36.e86
pmc: PMC8021978
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e86Subventions
Organisme : Korea National Institute of Health
ID : 2019 ER7103 02#
Pays : Korea
Informations de copyright
© 2021 The Korean Academy of Medical Sciences.
Déclaration de conflit d'intérêts
The authors have no potential conflicts of interest to disclose.
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