Document Detail

Outcome of very-low-birth-weight infants: are populations of neonates inherently different after antenatal versus neonatal referral?
MedLine Citation:
PMID:  2929672     Owner:  NLM     Status:  MEDLINE    
Postnatal transfer of high-risk infants to a neonatal intensive care unit has been an accepted medical practice for more than two decades. More recently, antepartum maternal referral for the smallest infants has been recommended to reduce infant mortality, morbidity, and long-term handicaps. The limited data available to compare in utero and postnatal transfer suggest that maternal risk factors may also influence antenatal referral. We evaluated antepartum maternal and postnatal infant referrals from five metropolitan Denver hospitals with level I facilities. Mothers who were referred to the tertiary perinatal center before delivery were more likely to have one or more high-risk conditions. The presence of a maternal risk factor (preeclampsia, antepartum bleeding, prolonged rupture of the membranes, or chorioamnionitis) was significantly more common in the maternal transfer group (p less than 0.002). Neonatal weight was higher for the maternal referrals compared with neonatal referrals. Neonatal survival was independently improved by transport of mother or infant, increasing birth weight, and higher Apgar scores. We suggest that maternal risk factors were an important determinant in the choice of antenatal referral to our perinatal center for both the community and regional hospitals during this study period. Studies that compare outcome of infants after maternal and infant transfer must control for potentially inherent differences between the antenatally and postnatally transferred infants.
V Delaney-Black; L O Lubchenco; L J Butterfield; E Goldson; B L Koops; D C Lazotte
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  160     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1989 Mar 
Date Detail:
Created Date:  1989-04-21     Completed Date:  1989-04-21     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  545-52     Citation Subset:  AIM; IM    
Department of Pediatrics, Wayne State University, Detroit, Michigan.
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MeSH Terms
Child Development*
Infant Mortality
Infant, Low Birth Weight / growth & development*
Infant, Newborn
Postnatal Care*
Prenatal Care*
Referral and Consultation*
Transportation of Patients
Grant Support

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