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Impact of neonatologist availability on preterm survival without morbidities

Journal of Perinatology volume 38, pages 1009–1016 (2018)Cite this article

Subjects

Abstract

Objectives

We assessed birth hospital level and neonatal outcomes within a model of regionalization featuring neonatologists at all levels of care, including well-baby nurseries without an accompanying neonatal intensive care unit.

Methods

Data were analyzed by NY State adaptation of American Academy of Pediatrics defined levels of care; n = 998, 23–30 weeks gestational age, 400–1250 g birth weight, and admitted to the regional center (2006–2015). Primary outcomes were survival, neurologic survival, and intact survival.

Results

Level III hospitals transferred 82% of neonates ≥24 h of life compared to ≤2% at Level I or II hospitals (p < 0.05). Primary outcomes were equivalent for Levels I vs. II born neonates with similar postnatal age at transfer and similar to inborn rates (Levels I and II vs. IV).

Conclusions

When transferred within 24 h, Levels I or II born infants had equivalent outcomes to inborn Level IV infants in a model of neonatologist availability at all deliveries.

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Acknowledgements

We thank Sergio Golombek, MD, Yogangi Malhotra, MD, and James Hagadorn, MD, MS for their helpful discussions. We also acknowledge Donna Dozor, RN, MS who maintains quality control of the data from which this study was based. We appreciate the physicians and staff of the Maria Fareri Children’s Hospital Regional Perinatal Center who enable this system to function effectively. This project was funded in part by New York State Department of Health, Division of Family Health.

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Authors and Affiliations

  1. Department of Pediatrics, Division of Newborn Medicine, Maria Fareri Children’s Hospital at Westchester Medical Center, New York Medical College, Valhalla, NY, 10595, USA

    David Aboudi, Shetal I. Shah, Edmund F. La Gamma & Heather L. Brumberg

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  1. David Aboudi
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  2. Shetal I. Shah
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Correspondence to Heather L. Brumberg.

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Aboudi, D., Shah, S.I., La Gamma, E.F. et al. Impact of neonatologist availability on preterm survival without morbidities. J Perinatol 38, 1009–1016 (2018). https://doi.org/10.1038/s41372-018-0103-1

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