Bibliographic Details
| Title: |
Variability of Care Practices for Extremely Early Deliveries. |
| Authors: |
LoRe, Danielle1, Groden, Catherine M.2 catherine.groden@bsd.uchicago.edu, Schuh, Allison R.3, Holmes, Chondraah4, Ostilla, Lorena5, Vogel, Maggie M.6, Murray, Peter D.7, Yamasato, Kelly8, Tonismae, Tiffany9, Anani, Uchenna E.10, Henner, Natalia5, Famuyide, Mobolaji11, Leuthner, Steven R.4, Laventhal, Naomi12, Andrews, Bree Landis3, Tucker Edmonds, Brownsyne M.13, Brennan, Kathleen G.1, Feltman, Dalia M.14 |
| Source: |
Pediatrics. Sep2024, Vol. 154 Issue 3, p1-9. 9p. |
| Subject Terms: |
*VERY low birth weight, *ADRENOCORTICAL hormones, *CESAREAN section, *RESEARCH funding, *NEONATOLOGY, *DATA analysis, *PREMATURE infants, *FISHER exact test, *MULTIPLE regression analysis, *RETROSPECTIVE studies, *RESUSCITATION, *MULTIVARIATE analysis, *CHI-squared test, *MANN Whitney U Test, *PEDIATRICS, *PRENATAL care, *RACE, *LONGITUDINAL method, *ODDS ratio, *GESTATIONAL age, *RESEARCH, *STATISTICS, *BIRTH weight, *CONFIDENCE intervals, *DATA analysis software, *MEDICAL referrals, *CHILDBIRTH, *OVERALL survival, *BIRTHING centers |
| Geographic Terms: |
UNITED States |
| Abstract: |
OBJECTIVES: Assess temporal changes, intercenter variability, and birthing person (BP) factors relating to interventions for extremely early deliveries. METHODS: Retrospective study of BPs and newborns delivered from 22-24 completed weeks at 13 US centers from 2011-2020. Rates of neonatology consultation, antenatal corticosteroids, cesarean delivery, live birth, attempted resuscitation (AR), and survival were assessed by epoch, center, and gestational age. RESULTS: 2028 BPs delivering 2327 newborns were included. Rates increased in epoch 2--at 22 weeks: neonatology consultation (37.6 vs 64.3%, P < .001), corticosteroids (11.4 vs 29.5%, P < .001), live birth (66.2 vs 78.6%, P < .001), AR (20.1 vs 36.9%, P < .001), overall survival (3.0 vs 8.9%, P = .005); and at 23 weeks: neonatology consultation (73.0 vs 80.5%, P = .02), corticosteroids (63.7 vs 83.7%, P < .001), cesarean delivery (28.0 vs 44.7%, P < .001), live birth (88.1 vs 95.1%, P < .001), AR (67.7 vs 85.2%, P < .001), survival (28.8 vs 41.6%, P < .001). Over time, intercenter variability increased at 22 weeks for corticosteroids (interquartile range 18.0 vs 42.0, P = .014) and decreased at 23 for neonatology consultation (interquartile range 23.0 vs 5.2, P = .045). In BP-level multivariate analysis, AR was associated with increasing gestational age and birth weight, Black BP race, previous premature delivery, and delivery center. CONCLUSIONS: Intervention rates for extremely early newborns increased and intercenter variability changed over time. In BP-level analysis, factors significantly associated with AR included Black BP race, previous premature delivery, and center. [ABSTRACT FROM AUTHOR] |
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| Database: |
Academic Search Complete |
