Survival rates for premature babies in high-level NICUs are better than previously reported

July 23, 2012

Premature babies are more likely to survive when they are born in high-level neonatal intensive care units (NICUs) than in hospitals without such facilities, and this benefit is considerably larger than previously reported.

The likelihood that an extremely premature baby will survive if born in a high-technology, high-volume hospital unit was already known, but the current study, the largest to date, revealed a stronger effect. Pediatric researchers who analyzed more than 1.3 million premature births over a 10-year span found that the survival benefits applied not only to extremely , but also to moderately preterm .

The research team performed a of all hospital-based deliveries of infants with a gestational age between 23 and 37 weeks in Pennsylvania, California and Missouri—a total of over 1,328,000 births. The study focused on preterm deliveries in high-level NICUs, compared to preterm at all other hospitals.

"Prior studies from the early 1990s found increased survival rates of 30 to 50 percent among preterm infants delivered at high-level NICUs, compared to preterm infants delivered elsewhere," said study leader Scott A. Lorch, M.D., a neonatologist at The Children's Hospital of Philadelphia. "However, our research found rates as high as 300 percent improvement, when our study design controlled for the effect of sicker patients who typically deliver at high-level NICUs." Complication rates were similar for both types of hospitals.

The retrospective study, which appeared online July 9 in the journal Pediatrics, analyzed records for all births occurring between 1995 and 2005 in Pennsylvania and California, and all births between 1995 and 2003 in Missouri. Lorch added that the results varied slightly among the states, possibly reflecting state-level differences in health policies, such as whether or not the state government designated hospitals within a regional perinatal system.

are those born before 37 weeks (full term is 40 weeks). In this study, the researchers defined extremely preterm infants as those born before 32 weeks and moderately preterm infants as those born between 32 and 37 weeks. They defined a high-level NICU as a level III facility that delivered at least 50 very low birth weight infants annually. "We found survival benefits in high-level NICUs for both extremely premature and moderately premature infants," said Lorch. "This suggests that the choice of a delivery hospital may influence the outcomes for the full range of preterm infants."

Unlike many previous analyses of birth outcomes, said Lorch, the current study covered more than a single state system. Using hospital data from states in three regions of the country suggests that the results may be more generalizable throughout the United States than in more limited studies, he added.

However, concluded Lorch, "this research does not imply that every hospital should aspire to build a high-tech NICU—there just aren't enough babies born prematurely for every birth in the U.S. to have a high-level, high-volume NICU. Instead, the results may assist health care policy makers in organizing regional and statewide care systems to more efficiently provide the best care for premature infants within a geographical area."

Explore further: Preemies still receive inhaled nitric oxide despite lack of supporting evidence and standards

More information: "The Differential Impact of Delivery Hospital on the Outcomes of Premature Infants," Pediatrics, published online July 9, 2012, and in print, August 2012. doi:10.1542/peds.2011-2820

Related Stories

Preemies still receive inhaled nitric oxide despite lack of supporting evidence and standards

March 12, 2012
Many premature infants throughout the United States continue to receive inhaled nitric oxide (iNO) during their NICU stay, despite the lack of evidence to support its use. Whether or not a preemie will receive iNO treatment, ...

Surviving premature babies in Malawi continue to have poor growth rates and development delay

November 8, 2011
A detailed study from Malawi, published in this week's PLoS Medicine, shows that during the first 2 years of life, infants who were born prematurely (before 37 weeks gestation) continue to have a higher risk of death than ...

Study identifies risk factors associated with death of extremely low birth weight infants after NICU

February 9, 2012
Preterm infants born with extremely low birth weights have an increased risk of death during the first year of life. Although researchers have extensively studied risk factors that could contribute to the death of preterm ...

Babies born 32-36 weeks fare less well at school

December 8, 2011
(Medical Xpress) -- Only 71 per cent of babies born between 32 and 36 weeks are successful in key stage 1 (KS1) tests (defined as achieving at least level 2 in reading, writing and maths), compared to 79 per cent of babies ...

Recommended for you

Higher blood sugar in early pregnancy raises baby's heart-defect risk

December 15, 2017
Higher blood sugar early in pregnancy raises the baby's risk of a congenital heart defect, even among mothers who do not have diabetes, according to a study led by researchers at the Stanford University School of Medicine.

Injuries from window blinds send two children to the emergency department every day

December 11, 2017
Most homes have them. They help keep our rooms warm or cold and even add a pop of color to tie the décor together. But window blinds can cause serious injuries or even death to young children. A new study from the Center ...

Blood flow altered in brains of preterm newborns vs. full-term infants

December 4, 2017
Cerebral blood flow (CBF) of key regions of newborns' brains is altered in very premature infants and may provide an early warning sign of disturbed brain maturation well before such injury is visible on conventional imaging, ...

HPV vaccine is effective, safe 10 years after it's given

November 29, 2017
A decade of data on hundreds of boys and girls who received the HPV vaccine indicates the vaccine is safe and effective long term in protecting against the most virulent strains of the virus, researchers report.

Antibiotics administered during labor delay healthy gut bacteria in babies

November 28, 2017
Antibiotics administered during labour for Group B Streptococcus (GBS) affect the development of gut bacteria in babies, according to a study from McMaster University.

Stress in pregnancy linked to changes in infant's nervous system, less smiling, less resilience

November 23, 2017
Maternal stress during the second trimester of pregnancy may influence the nervous system of the developing child, both before and after birth, and may have subtle effects on temperament, resulting in less smiling and engagement, ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.