低住院产生量与农村地区接受治疗性低温治疗的新生儿不良短期结局的关系

IF 2.4 3区医学 Q2 OBSTETRICS & GYNECOLOGY

Journal of Perinatology Pub Date : 2025-07-06 DOI:10.1038/s41372-025-02352-8

Alexa K Craig, Anya Cutler, Jay Kerecman, Misty Melendi, Leah Marie Seften, Matthew Ryzewski, Allison Zanno, Deirdre O'Reilly

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引用次数: 0

摘要

目的：我们假设三个农村州的早产新生儿在治疗性低温（TH）后会有更频繁的不良短期结果。研究设计：多中心回顾性研究，比较新英格兰北部低产生量医院（1500例/年）的结果。多变量logistic回归评估MRI上死亡/严重灰质损伤的综合结果，控制脑病严重程度和开始TH的时间。结果：35/531例新生儿死亡：低15/120例（12%），中7/193例（4%），高产生量医院13/218例（6%）（p = 0.008）。重度灰质损伤发生率分别为低、中、高产生量医院的8%、6%和7% （p = 0.7）。综合结果的几率在低容量医院比高容量医院高4.3倍（95% CI = 1.6, 12.1, p = 0.004）。结论：在小容量医院出生的新生儿在接受TH治疗后死亡的几率明显较高。

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Association of low hospital birth volume and adverse short-term outcomes for neonates treated with therapeutic hypothermia in rural states.

Objective: We hypothesized that outborn neonates in three rural states would have more frequent adverse short-term outcomes following therapeutic hypothermia (TH).

Study design: Multicenter retrospective study comparing outcomes for low (<500 births/year), medium (501-1500 births/year), and high (>1500 births/year) birth volume hospitals in Northern New England. Multivariable logistic regression assessed the combined outcome of death/severe gray matter injury on MRI, controlling for encephalopathy severity and time to initiation of TH.

Results: Death occurred for 35/531 neonates: 15/120 (12%) low, 7/193 (4%) medium, and 13/218 (6%) for high birth volume hospitals (p = 0.008). Severe gray matter injury occurred in 8%, 6% and 7% of low, medium, and high birth volume hospitals, respectively (p = 0.7). Odds of the combined outcome were 4.3-fold higher in low versus high volume hospitals (95% CI = 1.6, 12.1, p = 0.004).

Conclusion: Neonates born in low volume birth hospitals had significantly higher odds of death following treatment with TH.

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来源期刊

Journal of Perinatology 医学-妇产科学

CiteScore

5.40

自引率

6.90%

发文量

284

审稿时长

3-8 weeks

期刊介绍： The Journal of Perinatology provides members of the perinatal/neonatal healthcare team with original information pertinent to improving maternal/fetal and neonatal care. We publish peer-reviewed clinical research articles, state-of-the art reviews, comments, quality improvement reports, and letters to the editor. Articles published in the Journal of Perinatology embrace the full scope of the specialty, including clinical, professional, political, administrative and educational aspects. The Journal also explores legal and ethical issues, neonatal technology and product development. The Journal’s audience includes all those that participate in perinatal/neonatal care, including, but not limited to neonatologists, perinatologists, perinatal epidemiologists, pediatricians and pediatric subspecialists, surgeons, neonatal and perinatal nurses, respiratory therapists, pharmacists, social workers, dieticians, speech and hearing experts, other allied health professionals, as well as subspecialists who participate in patient care including radiologists, laboratory medicine and pathologists.