Document Detail


Congenital heart disease: the impact of delivery in a tertiary care center on SNAP scores (scores for neonatal acute physiology).
MedLine Citation:
PMID:  10649177     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: It has been hypothesized that delivery in a tertiary care center might improve the clinical condition and outcome of infants born with congenital heart disease. The purpose of this study was to determine the effect of delivery in a tertiary care center on SNAP scores (scores for neonatal acute physiology) of infants admitted to the neonatal intensive care unit with major structural cardiac defects. STUDY DESIGN: This retrospective cohort study included 195 infants with major congenital heart disease admitted to the neonatal intensive care unit at the New England Medical Center between July 1, 1992, and June 30, 1998. SNAP scores were abstracted from the medical record. The values of 97 neonates with major cardiac defects born at the New England Medical Center were compared with those of 98 neonates transferred to our center after delivery in a community setting. A 2-tailed Student t test for independent samples was used to compare the mean SNAP scores between the 2 cohorts. RESULTS: The SNAP scores for infants with major cardiac defects who were born at the New England Medical Center ranged from 0 to 41, with a mean of 10.6 +/- 8.8. The values for infants with congenital heart disease who were transferred to our center after birth in community-based hospitals ranged from 0 to 34, with a mean of 11.1 +/- 7.0. There was no significant difference between the 2 populations (P =.646). A comparison of the mean SNAP scores of infants with prenatally diagnosed disease who were delivered at our center versus infants with postnatally diagnosed disease who were delivered in community hospitals was also statistically not significant (P =.824). CONCLUSION: Delivery in a tertiary care center does not improve SNAP scores of infants with major structural cardiac defects.
Authors:
L L Simpson; K Harvey-Wilkes; M E D'Alton
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  182     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  2000 Jan 
Date Detail:
Created Date:  2000-02-17     Completed Date:  2000-02-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  184-91     Citation Subset:  AIM; IM    
Affiliation:
Departments of Obstetrics and Gynecology and Pediatrics, New England Medical Center, Tufts University School of Medicine, Boston, MA 02111, USA.
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MeSH Terms
Descriptor/Qualifier:
Alprostadil / therapeutic use
Birth Weight
Cohort Studies
Delivery, Obstetric*
Female
Gestational Age
Heart Catheterization
Heart Defects, Congenital / mortality,  surgery,  therapy*
Humans
Infant, Newborn
Intensive Care, Neonatal*
Intubation
Male
Physical Examination*
Prenatal Diagnosis
Respiration, Artificial
Retrospective Studies
Treatment Outcome
Chemical
Reg. No./Substance:
745-65-3/Alprostadil

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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