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

Small drop in measles vaccinations would have outsized effect, study estimates

July 24, 2017
Small reductions in childhood measles vaccinations in the United States would produce disproportionately large increases in the number of measles cases and in related public health costs, according to a new study by researchers ...

At the cellular level, a child's loss of a father is associated with increased stress

July 18, 2017
The absence of a father—due to incarceration, death, separation or divorce—has adverse physical and behavioral consequences for a growing child. But little is known about the biological processes that underlie this link ...

New comparison chart sheds light on babies' tears

July 10, 2017
A chart that enables parents and clinicians to calculate if a baby is crying more than it should in the first three months of its life has been created by a Kingston University London researcher, following a study of colic ...

Blood of SIDS infants contains high levels of serotonin

July 3, 2017
Blood samples from infants who died of Sudden Infant Death Syndrome (SIDS) had high levels of serotonin, a chemical that carries signals along and between nerves, according to a study funded in part by the National Institutes ...

Is your child's 'penicillin allergy' real?

July 3, 2017
(HealthDay)—Many children suspected of being allergic to the inexpensive, first-line antibiotic penicillin actually aren't, new research indicates.

Probiotic supplements failed to prevent babies' infections

July 3, 2017
(HealthDay)—Probiotic supplements may not protect babies from catching colds or stomach bugs in day care, a new clinical trial suggests.

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.