Title

Perinatal risk and severity of illness in newborns at 6 neonatal intensive care units

UMMS Affiliation

Department of Pediatrics

Date

4-1999

Document Type

Article

Medical Subject Headings

Anti-Inflammatory Agents; Apgar Score; Congenital Abnormalities; Continental Population Groups; Diagnosis-Related Groups; *Gestational Age; Humans; Hypothermia; Infant, Newborn; Infant, Newborn, Diseases; Intensive Care Units, Neonatal; Linear Models; Massachusetts; Predictive Value of Tests; Prenatal Care; Prospective Studies; Rhode Island; Risk Factors; *Severity of Illness Index; Steroids

Disciplines

Pediatrics

Abstract

OBJECTIVES: This multisite study sought to identify (1) any differences in admission risk (defined by gestational age and illness severity) among neonatal intensive care units (NICUs) and (2) obstetric antecedents of newborn illness severity.

METHODS: Data on 1476 babies born at a gestational age of less than 32 weeks in 6 perinatal centers were abstracted prospectively. Newborn illness severity was measured with the Score for Neonatal Acute Physiology. Regression models were constructed to predict scores as a function of perinatal risk factors.

RESULTS: The sites differed by several obstetric case-mix characteristics. Of these, only gestational age, small for gestational age. White race, and severe congenital anomalies were associated with higher scores. Antenatal corticosteroids, low Apgar scores, and neonatal hypothermia also affected illness severity. At 2 sites, higher mean severity could not be explained by case mix.

CONCLUSIONS: Obstetric events and perinatal practices affect newborn illness severity. These risk factors differ among perinatal centers and are associated with elevated illness severity at some sites. Outcomes of NICU care may be affected by antecedent events and perinatal practices.

Rights and Permissions

Citation: Am J Public Health. 1999 Apr;89(4):511-6.

Related Resources

Link to Article in PubMed

PubMed ID

10191793