Does earlier arrival of the retrieval team improve short-term outcomes in outborn extremely premature infants?
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Janet B Sharpe1, Mark W Davies1,2
1Grantley Stable Neonatal Unit, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
Insights
Earlier retrieval team arrival for extremely premature infants does not significantly improve survival or reduce severe intraventricular hemorrhage. This study found no association between retrieval team timing and better short-term outcomes in these vulnerable newborns.
Area of Science:
- Neonatal medicine
- Perinatal care
- Pediatric critical care
Background:
- Outborn, extremely premature infants (<29 weeks gestation) face elevated mortality and morbidity risks.
- Timely medical intervention is crucial for improving outcomes in this high-risk population.
Purpose of the Study:
- To investigate if earlier retrieval team arrival impacts short-term mortality and morbidity in extremely premature infants.
- To assess the association between retrieval team response time and infant outcomes.
Main Methods:
- Retrospective analysis of 105 infants (<29 weeks gestation) retrieved to a tertiary neonatal intensive care unit over 5 years.
- Data collected included infant/maternal demographics, retrieval team arrival time, and outcomes (mortality, severe intraventricular hemorrhage).
Main Results:
- 83.8% of infants survived to discharge, and 75.2% survived without severe intraventricular hemorrhage (IVH).
- Univariate and logistic regression analyses showed no significant association between retrieval team arrival time and reduced mortality or severe IVH.
Conclusions:
- Earlier arrival of the retrieval team (within ~8 hours of birth) is not linked to improved short-term outcomes for outborn, extremely preterm infants.
- Current retrieval practices may not be significantly influenced by arrival time for these infants admitted to a tertiary NICU.
Aim:
The risk of mortality and morbidity is increased in outborn, extremely premature infants. We aim to determine whether earlier arrival of the retrieval team after the birth of infants less than 29 weeks gestation improves short-term mortality and morbidity.
Methods:
This is a retrospective analysis of a cohort of infants less than 29 weeks gestation who were retrieved to the Royal Brisbane and Women's Hospital (RBWH) over a 5-year period. Demographic information regarding the infant and mother, retrieval team arrival time and outcome data was collected. Primary outcomes investigated were mortality prior to discharge from hospital or a composite of mortality or severe intraventricular haemorrhage (IVH).
Results:
Data on 105 infants were analysed; 88 infants (83.8%) survived to discharge home, and 79 (75.2%) survived to discharge without severe IVH. On univariate analysis, there was no significant association between age at arrival of the retrieval team and death prior to discharge (P = 0.94) or death prior to discharge or severe IVH (P = 0.83). On logistic regression analysis, age at arrival of retrieval team remained non-significant for a reduction in death prior to discharge and composite of death or severe IVH (P = 0.70 and P = 0.99, respectively).
Conclusion:
The earlier arrival of the retrieval team is not associated with improved short-term outcomes in outborn, extremely preterm infants who are retrieved and admitted to a tertiary neonatal intensive care unit - for infants where the retrieval team arrived within about 8 h of birth.
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