Document Detail


Maternal and neonatal separation and mortality associated with concurrent admissions to intensive care units.
MedLine Citation:
PMID:  23091180     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Concurrent admission of a mother and her newborn to separate intensive care units (herein referred to as co-ICU admission), possibly in different centres, can magnify family discord and stress. We examined the prevalence and predictors of mother-infant separation and mortality associated with co-ICU admissions.
METHODS: We completed a population-based study of all 1 023 978 singleton live births in Ontario between Apr. 1, 2002, and Mar. 31, 2010. We included data for maternal-infant pairs that had co-ICU admission (n = 1216), maternal ICU admission only (n = 897), neonatal ICU (NICU) admission only (n = 123 236) or no ICU admission (n = 898 629). The primary outcome measure was mother-infant separation because of interfacility transfer.
RESULTS: The prevalence of co-ICU admissions was 1.2 per 1000 live births and was higher than maternal ICU admissions (0.9 per 1000). Maternal-newborn separation due to interfacility transfer was 30.8 (95% confidence interval [CI] 26.9-35.3) times more common in the co-ICU group than in the no-ICU group and exceeded the prevalence in the maternal ICU group and NICU group. Short-term infant mortality (< 28 days after birth) was higher in the co-ICU group (18.1 per 1000 live births; maternal age-adjusted hazard ratio [HR] 27.8, 95% CI 18.2-42.6) than in the NICU group (7.6 per 1000; age-adjusted HR 11.5, 95% CI 10.4-12.7), relative to 0.7 per 1000 in the no-ICU group. Short-term maternal mortality (< 42 days after delivery) was also higher in the co-ICU group (15.6 per 1000; age-adjusted HR 328.7, 95% CI 191.2-565.2) than in the maternal ICU group (6.7 per 1000; age-adjusted HR 140.0, 95% CI 59.5-329.2) or the NICU group (0.2 per 1000; age-adjusted HR 4.6, 95% CI 2.8-7.4).
INTERPRETATION: Mother-infant pairs in the co-ICU group had the highest prevalence of separation due to interfacility transfer and the highest mortality compared with those in the maternal ICU and NICU groups.
Authors:
Joel G Ray; Marcelo L Urquia; Howard Berger; Marian J Vermeulen
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-10-22
Journal Detail:
Title:  CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne     Volume:  184     ISSN:  1488-2329     ISO Abbreviation:  CMAJ     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-11     Completed Date:  2013-02-12     Revised Date:  2013-07-11    
Medline Journal Info:
Nlm Unique ID:  9711805     Medline TA:  CMAJ     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  E956-62     Citation Subset:  AIM; IM    
Affiliation:
rayj@smh.ca
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MeSH Terms
Descriptor/Qualifier:
Adult
Asphyxia Neonatorum / epidemiology
Cesarean Section / statistics & numerical data
Congenital Abnormalities / epidemiology
Extraction, Obstetrical / statistics & numerical data
Female
Hospital Mortality
Humans
Infant
Infant Mortality*
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature, Diseases / epidemiology
Intensive Care Units*
Intensive Care Units, Neonatal*
Kidney Diseases / epidemiology
Length of Stay
Maternal Mortality*
Obstetrical Forceps
Ontario / epidemiology
Parity
Patient Admission*
Patient Transfer
Postpartum Hemorrhage / epidemiology
Pre-Eclampsia / epidemiology
Pregnancy
Premature Birth / epidemiology
Proportional Hazards Models
Retrospective Studies
Risk Factors
Comments/Corrections

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


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