1466 MATERNAL REFERRAL VERSUS NEONATAL TRANSPORT TO A PERINATAL CENTER: A COMPARISON BETWEEN THE OUTCOME OF MATCHED MOTHERS AND THEIR INFANTS

Abstract

To study the possible benefits of maternal referral over neonatal transport to a perinatal center, the clinical courses of 50 matched pairs of infants admitted to the intensive care nursery (ICN) were compared. The two groups of infants were matched for birth weight and gestational age. Then their mothers were matched for several maternal conditions: onset of labor prior to 37 weeks gestation, membrane rupture prior to labor, preeclampsia or eclampsia, and uterine bleeding. The infant groups were studied to compare their immediate postnatal clinical status in the delivery room, complications in the ICN, and death rates. There was no difference between them for C-section rates, Apgar scores, nor the incidence of retrolental fibroplasia, broncho-pulmonary dysplasia, intraventricular hemorrhage or necrotizing enterocolitis, nor the lengths of time mechanically ventilated and lengths of stay in the ICN. The infants delivered in the perinatal center after maternal referral had a significantly lower incidence of cold stress (axillary temp < 36.5°C.) and neonatal death rate. The death rate of the postnatally transported infants was lower than the death rates of the similar infants remaining in the referring hospitals. We concluded that maternal referral to a perinatal center reduces neonatal mortality when the infant requires neonatal intensive care.

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