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Population study of neurodevelopmental outcomes of extremely premature infants admitted after office hours

Authors

  • Mohamed E Abdel-Latif,

    1. Department of Neonatology, Canberra Hospital, Woden
    2. School of Clinical Medicine, Australian National University, Canberra, Australian Capital Territory
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  • Barbara Bajuk,

    1. Neonatal Intensive Care Units' Data Collection, NSW Pregnancy and Newborn Service Network, Sydney
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  • Julee Oei,

    1. Department of Newborn Care, Royal Hospital for Women, Randwick
    2. School of Women's and Children's Heath, University of New South Wales, New South Wales, Australia
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  • Kei Lui,

    Corresponding author
    1. Department of Newborn Care, Royal Hospital for Women, Randwick
    2. School of Women's and Children's Heath, University of New South Wales, New South Wales, Australia
    • Correspondence: Associate Professor Kei Lui, Department of Newborn Care, Royal Hospital for Women, Barker Street, Randwick, NSW 2031, Australia. Fax: +61 2 9382 6191; email: kei.lui@sesiahs.health.nsw.gov.au

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  • the NSW and ACT Neonatal Intensive Care Units Audit Group

    1. Neonatal Intensive Care Units' Data Collection, NSW Pregnancy and Newborn Service Network, Sydney
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  • Conflict of interest: Nothing to declare.
  • Funding source: Nil.

Abstract

Aim

The aim of the study was to compare neurodevelopmental outcomes of extremely preterm infants admitted during (OH) and after (AH) office hours.

Methods

A retrospective review of the New South Wales and Australian Capital Territory Neonatal Intensive Care Units' (NICUs) Data Collection of all infants <29 weeks gestation admitted to New South Wales and Australian Capital Territory NICUs between January 1998 and December 2004 was conducted. The primary outcome was moderate/severe functional disability (FD) at 2–3 years follow-up defined as developmental delay (Griffiths Mental Developmental Scales general quotient or Bayley Scales of Infant Development-II mental developmental index >2 standard deviations below the mean), cerebral palsy (unable to walk without aids), deafness (requiring bilateral hearing aids) or blindness (visual acuity <6/60 in the better eye).

Results

Mortality and age at follow-up were comparable between the AH and OH groups. Developmental outcome was evaluated in 972 (74.9%) infants admitted during AH and 501 (74.6%) admitted during OH. FD was not significantly different between the AH and OH groups (17.1% vs. 14.8%, adjusted odds ratio 1.131, 95% confidence interval 1.131 (0.839–1.523), P = 0.420). There were no significant differences between AH and OH infants with cerebral palsy (9.6% vs. 7.6%), developmental delay (5.4% vs. 5.0%) or any other component of FD.

Conclusion

There is little circadian variation in mortality and adverse neurodevelopmental outcomes in an NICU network with the current model of after hours staffing and support, and sharing of NICU workload within a network.

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