| Titre : | Perinatal risk and severity of illness in newborns at 6 neonatal intensive care units. (1999) |
| Auteurs : | D.K. RICHARDSON ; F. BEDNAREK ; Idiii FRANTZ ; M.C. MCCORMICK ; L.P. RUBIN ; B.L. SHAH ; Joint Program in Neonatology Beth Israel Deaconess Medical Center. Brigham and Women's Hospital. And Children's Hospital. With Harvard Medical School and with the Department of Maternal and Child Health. Harvard School of Public Health. Boston. MA. USA |
| Type de document : | Article |
| Dans : | American journal of public health (vol. 89, n° 4, 1999) |
| Pagination : | 511-516 |
| Langues: | Anglais |
| Mots-clés : | Morbidité périnatale ; Morbidité ; Service admission ; Entrée ; Gestation [pathologie] ; Accouchement [pathologie] ; Incidence ; Facteur risque ; Nouveau né ; Homme ; Etats Unis ; Amérique ; Morbidité [épidémiologie] ; Epidémiologie ; Soins intensifs ; Structure hospitalière ; Amérique du Nord |
| Résumé : | [BDSP. Notice produite par INIST aJaXR0xA. Diffusion soumise à autorisation]. Objectives. This multi site study sought to identify (1) any differences in admission risk (defined by gestational age and illness severity) among neonatal intensive care units (NICUs) and (2) obstetric antecedents of new-born illness severity. Methods. Data on 1476 babies born at a gestational age of less than 32 weeks in 6 perinatal centers were diffracted prospectively. Newborn illness severity was measured with the score for Neonatal Acute Physiology. Progression models were constructed to predict scores as a function of perinatal with factors. Results. The sites differed by seveval obstetric case-mix characteristics. Of these, only gestational age, small for gestational age, White race, and severe congenital anomalies were associated with higher scores. Antenatal corticosteroids, low Apgar scores, and neonatal hyopothermia also affected illness seversity. At 2 sites, higher mean severity could not be explained by case mix. Conclusions. Obstetric events and perinatal practices affect newborn illness severity. These risk factors differ among perinatal centers and are associated with elevated illness severity at some sites. Outcomes of NICU care may be affected by antecedent events and perinatal practices. |
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