This multi site 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 new-born illness severity.
Data on 1476 babies born at a gestational age of less than 32 weeks in 6 perinatal centers were diffracted prospectively.
Newborn illness severity was measured with the score for Neonatal Acute Physiology.
Progression models were constructed to predict scores as a function of perinatal with factors.
The sites differed by seveval 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 hyopothermia also affected illness seversity.
At 2 sites, higher mean severity could not be explained by case mix.
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.
Mots-clés Pascal : Unité soin intensif, Morbidité, Périnatal, Admission hôpital, Indice gravité, Nouveau né pathologie, Age gestation, Gestation pathologie, Accouchement pathologie, Incidence, Facteur risque, Nouveau né, Homme, Rhode Island, Etats Unis, Amérique du Nord, Amérique, Epidémiologie, Soin intensif, Service hospitalier
Mots-clés Pascal anglais : Intensive care unit, Morbidity, Perinatal, Hospital admission, Severity score, Newborn diseases, Gestational age, Pregnancy disorders, Delivery disorders, Incidence, Risk factor, Newborn, Human, Rhode Island, United States, North America, America, Epidemiology, Intensive care, Hospital ward
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0227385
Code Inist : 002B20G03. Création : 16/11/1999.