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Mortality and Morbidities according to Time of Birth in Extremely Low Birth Weight Infants

Misun Yang1, So Yoon Ahn1,2, Heui Seung Jo1

  • 1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Journal of Korean Medical Science
|April 6, 2021
PubMed

Insights

Off-hour births in high-risk preterm infants did not increase mortality in all centers. However, infants born during off-hours at lower-quality neonatal intensive care units (NICUs) experienced higher early mortality.

Area of Science:

  • Neonatal Medicine
  • Perinatal Care
  • Healthcare Quality Research

Background:

  • Concerns persist regarding variations in neonatal care quality between off-hour and regular-hour births.
  • Limited data exists in Korea on the impact of birth timing on preterm infant outcomes.

Purpose of the Study:

  • To investigate the association between time of birth (off-hours vs. regular hours) and neonatal mortality and morbidities in very low birth weight preterm infants in Korea.
  • To analyze outcomes based on the level of neonatal intensive care unit (NICU) care.

Main Methods:

  • Analysis of 3,220 infants (< 1,000 g, 23-34 weeks gestation) from the Korean Neonatal Network (2013-2017).
  • Logistic regression used to compare mortality and major morbidities between off-hour (nighttime, weekend, holiday) and regular-hour births.
  • Institutes categorized into hospital groups I and II based on NICU care level and 23-24 week gestation infant mortality rates.

Main Results:

  • Off-hour births showed no increased risk of neonatal mortality or morbidities in the overall population and hospital group I.
  • Hospital group II (lower NICU care level) demonstrated significantly higher early mortality for off-hour births compared to regular-hour births.

Conclusions:

  • Improving overall NICU quality is crucial to reduce early mortality associated with off-hour births.
  • Further research is needed to identify sensitive indicators for evaluating NICU care quality.
Abstract

Keywords:
After-hours CareNeonatal Intensive CareNeonatal MortalityPreterm InfantsQuality of Health Care

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