BACKGROUND: The mortality rate after discharge from the intensive care unit (ICU) (so called post-ICU mortality) has remained high (8.6-23.6%) during the past 15 years. The object of this study was to examine the effects of the severity of illness at ICU discharge assessed using the Acute Physiology and Chronic ...

AIM: Illicit substance use during pregnancy is associated with an increased rate of perinatal complications. Our study examines if outcome of infants of substance-using mothers (ISMs) in the neonatal intensive care unit (NICU) setting is similar to unexposed infants (controls). METHODS: A prospective state-wide NICU study comparing ISMs to control ...

OBJECTIVE: We conducted a population-based survey of caregivers of all preschoolers at 42 months of age who had been admitted at birth in 1996-1997 to a tertiary neonatal intensive care unit in British Columbia (BC), Canada. METHODS: In this paper, we examine health status (measured by Health Status Classification System ...

AIM: To investigate visiting frequency of family members, including mother, father, siblings and grandparents and associated factors during hospitalisation of preterm infants. METHODS: The study included all premature (< 37 weeks) infants born in Tampere University Hospital in 1997-1998 admitted to the neonatal intensive care unit (NICU) with a birth ...

The timely discharge of moderately premature infants has important economic implications. The decision to discharge should occur independent of unit census. We evaluated the impact of unit census on the decision to discharge moderately preterm infants. In a prospective multicenter cohort study, we enrolled 850 infants born between 30 and ...

In 2 prospective studies, we previously reported on the early and accurate diagnosis of invasive candidiasis by determining the D-arabinitol/L-arabinitol (DA/LA) ratio in urine in neutropenic children with cancer at the paediatric oncology unit (POU) and in premature infants at the neonatal intensive care unit (NICU) at our hospital. In ...

OBJECTIVE: Parents of preterm infants require information on morbidity and duration of common interventions performed in the NICU. Since locally achieved data are often not available, information is mainly based on educated guesses of health care professionals. The present study compares estimates of neonatal nurses or medical doctors (MDs) in ...

BACKGROUND: Increased maternal age is associated with increased rates of maternal hypertension, diabetes, growth restriction, and Caesarean section in pregnancy. However, there are few data on outcome and utilisation of neonatal resources by this group of infants. AIM: The primary aim was to determine how many infants born to women ...

Gaps between research knowledge and practice have been consistently reported. Traditional ways of communicating information have limited impact on practice changes. Strategies to disseminate information need to be more interactive and based on techniques reported in systematic reviews of implementation of changes. There is a need for clarification as to ...

Despite widespread use of neonatal hospital discharge data, there are few published reports on the accuracy of population health data with neonatal diagnostic or procedure codes. The aim of this study was to assess the accuracy of using routinely collected hospital discharge data in identifying neonatal morbidity during the birth ...

OBJECTIVE: To obtain information on the hospital mortality of infants born in Fortaleza with birth weights less than or equal to 1,500 g, and to compare it with data from the Vermont Oxford Network, a center of excellence for neonatal care. METHODS: Prospective cohort study, enrolling all infants with birth ...

AIM: To provide estimates of the first-year length of stay and inpatient costs of Swedish infants admitted for neonatal care by week of gestation and by birthweight; and to provide estimates of the length of stay and inpatient costs of delivering mothers during the ante- and postpartum period by week ...

The aim of this study was to examine the prevalence of maternal and newborn-care practices among women reporting a birth in the previous year in three districts in different divisions of Bangladesh. In 2003, 6,785 women, who had delivered a newborn infant in the previous year, across three districts in ...

OBJECTIVE: The objective of this study was to compare the primary and secondary outcomes of very low birth weight infants before and after participation in the Breathsavers Group of the Vermont Oxford Network-sponsored Neonatal Intensive Care Quality Collaborative. METHODS: Hospitals that participated in the Breathsavers Group contributed clinical data on ...

With advances in neonatal and obstetric care over the past few years, the number of premature, multiple-birth neonates entering NICUs has increased. As we have started to recognize the special bond that twins and higher multiples share, cobedding has emerged as an NICU practice. As with any change, the introduction ...

The survival rate of the smallest and youngest of premature infants has continued to improve as medical technology has progressed. The current edge of viability is represented by infants born at 23 to 25 weeks' gestation. Neonatal survival of infants at 23 weeks' gestation ranges from 11% to 30%. Survival ...

The use of oral nystatin to prevent fungal colonisation and infection in neonates in the Neonatal Intensive Care Unit (NICU) is still an open question and not yet recommended as a standard of care. To determine whether prophylactic oral nystatin results in a decreased incidence of invasive candidiasis in the ...

OBJECTIVE: To retrospectively determine if a negative 16S ribosomal RNA (rRNA) polymerase chain reaction (PCR) (PCR(-)) could lead to a decrease in the number of antibiotic doses and neonatal intensive care unit (NICU) length of stay (LOS) for infants admitted to the NICU for presumed early-onset sepsis (EOS) with negative ...

AIM: To determine length of hospital stay (LOS) for moderately preterm infants during the last 20 years, and to identify factors affecting the number of bed-days. METHODS: Review of LOS for all infants delivered between 30 to 34 gestational weeks during 1983, 1988, 1993, 1998 and 2002. Exclusion criteria: life-threatening ...

How do actual aspects of forgoing life supporting therapy (LST) in newborn infants compare with national ethical directives in a Swiss intensive care unit? A prospective set of data on deaths after forgoing LST over a three year period in a single intensive care unit is analysed in view of ...

The purpose of this study was to compare the duration of time that infants in child care centers were placed in infant seating devices to the duration of time spent on the floor or being held by child care providers. Thirty-eight infants who were typically developing (mean age = 4.5 ...

Premature infants born between 32 to 35 weeks' gestation have a 98% survival rate and comprise 84% of all preterm infants in the United States. These infants may have a relatively benign hospital course and may be considered by some to be a "healthy premature infant." At the time of ...

BACKGROUND: Death remains a common event in the neonatal intensive care unit, and often involves limitation or withdrawal of life sustaining treatment. OBJECTIVE: To document changes in the causes of death and its management over the last two decades. METHODS: An audit of infants dying in the neonatal intensive care ...

OBJECTIVE: Perinatal regionalization has been organized into 3 ascending levels of care, fitting increasing degrees of pathology. Current recommendations specify that very premature infants be referred prenatally to level III facilities, yet not all very preterm neonates require level III intensive care. The objective of our study was to determine ...

PURPOSE: The aim of the study was to describe the incidence and survival of infants born with congenital diaphragmatic hernia (CDH) in the state of New South Wales (NSW) and the Australian Capital Territory (ACT), Australia. METHODS: A population-based cohort study of all infants inclusive up to 1 month of ...

A subcategory of premature infants, those born near term at 34 to 36 and 6/7 weeks gestation, may represent a previously unrecognized at-risk neonatal population. Evidence-based practice guidelines, crafted specifically for this population, are needed to effectively manage their care. In an effort to meet the needs of the near-term ...

BACKGROUND: Outcome figures published in scientific journals are often cumbersome and difficult to understand by parents during counselling before or immediately after a very premature birth. AIM: To provide simplified up-to-date outcome information in a table for ease of counselling. METHODS: Regional perinatal mortality rates for very premature births (23-31 ...

BACKGROUND: Very low birth weight infants (< 1500 g) are at increased mortality risk. Data on the impact of NICU volume are sparse, in comparison with those on the level of care. We hypothesized that neonatal mortality would be higher in small NICUs (< 36 very low birth weight admissions ...

PURPOSE: Perinatal care of infants with congenital diaphragmatic hernia (CDH) is nonstandardized and costly. We examined a risk-adjusted cohort of patients with CDH and hypothesized that (1) among CDH survivors, the cost of the birth admission would be proportional to illness severity, and (2) this cost would be significantly higher ...

OBJECTIVE: To explore the effects of a guided participation (GP) intervention on mothers' development of competencies in relating to their preterm infants in neonatal intensive-care units. DESIGN: Mothers were enrolled in a randomized, longitudinal clinical trial to compare the effectiveness of GP with standard care teaching. Baseline data were collected ...

AIM: To compare the use and cost of health care in infants with different feeding patterns. METHODS: Observational study on a cohort of 842 infants born in ten hospitals in northern Italy and followed up to age 12 months. Data on feeding gathered through telephone interviews with 24-hour recall. Data ...

Infants are delicate, relying mostly on caregivers for their survival. Their survival is plagued by diseases, poverty, behavioural habits and cultural beliefs of the caregivers in the developing countries. For strategies to improve infant survival, the health seeking behaviour and home care practices of caregivers during infant illness episodes were ...

INTRODUCTION: Birth of very low birth weight (VLBW) infants outside subspecialty perinatal centers increases risk for death and major morbidities. OBJECTIVE: The purpose of this study is to evaluate barriers to utilizing a regional perinatal center for the birth of VLBW infants to mothers not living in the immediate vicinity ...

Appropriate length of delivery room resuscitative efforts for infants born without signs of life is controversial. We present the case of a preterm infant with Apgar scores of 0 at 1, 5, and 10 minutes but with a recovered heartbeat at 15 minutes. Using the clinically relevant conceptions of the ...

The Self-Efficacy in Infant Care Scale (SICS) is a self-administered measure to assess maternal judgments about the ability to care for the baby during the first year of life. The SICS was initially composed of 67 items and was tested on 397 Thai mothers with infants < 12 months old. ...

BACKGROUND: Very low birthweight (VLBW) infants contribute substantially to the workload and expenditure of any neonatal unit. Earlier discharge might offer advantages to the infant, the family and the health service. AIM: To establish the outcome of preterm, VLBW infants discharged at a weight of > or = 1650 g ...

Most neonates discharged from the hospital are able to go home in a standard car safety seat. Some infants, though, require special devices to ensure their safe travel. NICU nurses must have the knowledge and skills to comfortably and competently give vital information to parents preparing to take their infant ...

BACKGROUND: Newborns who are 35 to 36 weeks gestation comprise 7.0% of all live births and 58.3% of all premature infants in the United States. They have been studied much less than very low birth weight infants. OBJECTIVE: To examine available data permitting quantification of short-term hospital outcomes among infants ...

The health care use patterns, suspected maltreatment, and growth trajectories of siblings of infants with prenatal drug exposure were examined. Ninety-three siblings of drug-exposed infants were matched with patients from the same primary care clinic. The case patients were found to have significantly fewer health care contacts, more deficient immunizations, ...

BACKGROUND: The purpose of this study is to characterize variations in management late preterm infants because such variations in such a large group of neonates would have economic and health implications. METHODS: Comparison of the use of illustrative management approaches and gestational age at discharge among infants born at 33 ...

To compare gestational age at discharge between infants born at 30-34(+6) weeks gestational age who were admitted to neonatal intensive care units (NICUs) in California, Massachusetts, and the United Kingdom. Prospective observational cohort study. Fifty four United Kingdom, five California, and five Massachusetts NICUs. A total of 4359 infants who ...

OBJECTIVES: The goal of this report is to describe the collaborative formation of rational, practical, medical staff guidelines for the counseling and subsequent care of extremely early-gestation pregnancies and premature infants between 22 and 26 weeks. The purposes of the guidelines were to improve knowledge regarding neonatal outcomes, to provide ...

BACKGROUND: Prior research has shown that resources have an impact on birth outcomes. In this paper we ask how combinations of telemedical and hospital-level resources impact transports of mothers expecting very low birth weight (VLBW) babies in Arkansas. METHODS: Using de-identified birth certificate data from the Arkansas Department of Health, ...

OBJECTIVE: We sought to describe the current costs of newborn care by using population-based data, which includes linked vital statistics and hospital records for both mothers and infants. These data allow costs to be reported by episode of care (birth), instead of by hospitalization. METHODS: Data for this study were ...

PURPOSES: To provide descriptive information about the sound levels to which high-risk infants are exposed in various actual environmental conditions in the NICU, including the impact of physical renovation on sound levels, and to assess the contributions of various types of equipment, alarms, and activities to sound levels in simulated ...

BACKGROUND: Preterm prelabour rupture of membranes (PPROM) complicates up to 2% of all pregnancies and is the cause of 40% of all preterm births. The optimal management of women with PPROM prior to 37 weeks, is not known. Furthermore, diversity in current clinical practice suggests uncertainty about the appropriate clinical ...

Air transport of infants in incubators should be undertaken in a manner that is safe for both staff and infant and satisfies all directives by appropriate regulatory bodies. In Scotland during the last two years, certification of an infant incubator system for use in both rotary and fixed wing aircraft ...

PURPOSE: Elevated sound levels in the NICU may contribute to undesirable physiologic and behavioral effects in preterm infants. This study describes sound levels in a busy NICU in the southeastern U.S. and compares the findings with recommended NICU noise level standards. DESIGN: NICU sound levels were recorded continuously at nine ...

Most clinicians are keenly aware of the liability risks associated with adverse birth outcomes for mother and/or infant. This level of awareness and concern also needs to extend to the day-to-day management of office practice. Clinicians who care for healthy women and their families may see abnormalities infrequently. The low ...

INTRODUCTION:In a regionalized perinatal system, recovering neonates may be back transported from a regional Neonatal Intensive Care Unit (NICU) to community hospitals closer to their residence to convalesce prior to hospital discharge. OBJECTIVE:This study evaluates the practice of neonatal back transport for growth and the duration of total hospitalization. METHODS:We ...