Transfer Patterns Among Infants Born at 28 to 34 Weeks' Gestation

Area of Science:

• Neonatal care
• Pediatric transfer protocols
• Infant health outcomes

Background:

• Postnatal transfer patterns for high-risk infants are documented.
• Transfer patterns for lower-risk very and moderate preterm infants remain largely unknown.
• Understanding these patterns is crucial for optimizing care coordination.

Purpose of the Study:

• To examine the frequency, indications, timing, and trajectory of infant transfers.
• To analyze transfer data for very and moderate preterm infants.
• To inform best practices in neonatal care coordination.

Main Methods:

• Utilized the US Vermont Oxford Network NICU admissions database (2016-2021).
• Analyzed data for inborn infants between 28 0/7 and 34 6/7 weeks gestational age.
• Assessed first transfer characteristics including gestational age, age at transfer, reason, and trajectory.

Main Results:

• 4.3% of 294,229 eligible infants were transferred across 467 hospitals.
• Transfer proportion and age at transfer decreased with increasing gestational age.
• Common reasons included growth/discharge (45.0%) and medical/diagnostic services (30.2%); 46.7% transferred to lower-level units.

Conclusions:

• Over 4% of very and moderate preterm infants undergo transfer.
• Transfers in this population typically occur later, focusing on risk-appropriate care and discharge planning.
• Findings suggest transfers are not solely driven by immediate post-birth needs but by evolving care requirements.