Related Experiment Video
Updated: Jul 2, 2025
19:15
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
86.0K
Process and Outcome Measures for Infants Born Moderate and Late Preterm in Tertiary Canadian Neonatal Intensive Care
Ayman Abou Mehrem1, Jennifer Toye2, Marc Beltempo3
1Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.
The Journal of Pediatrics
|February 24, 2024
Summary
Care practices and clinical outcomes for moderate and late preterm infants (MLPIs) varied significantly across Canadian neonatal intensive care units (NICUs). Standardizing quality measures can improve care for these vulnerable newborns.
Area of Science:
- Neonatal Medicine
- Pediatric Critical Care
- Public Health
Background:
- Moderate and late preterm infants (MLPIs) represent a significant population within neonatal intensive care units (NICUs).
- Understanding variations in care practices and clinical outcomes for MLPIs is crucial for improving their management.
- Previous research has not fully elucidated the extent of variability in care and outcomes for MLPIs across Canadian NICUs.
Purpose of the Study:
- To determine the prevalence of specific care practices and clinical outcomes among MLPIs admitted to Canadian NICUs.
- To identify and quantify the between-center variations in these care practices and outcomes.
- To provide data for quality improvement initiatives and benchmarking within Canadian NICUs.
Main Methods:
- A retrospective cohort study was conducted using data from 25 tertiary NICUs in the Canadian Neonatal Network from 2015 to 2020.
- Infants born between 32 0/7 and 36 6/7 weeks of gestation were included.
- Care practices (e.g., deferred cord clamping, respiratory support, antibiotics) and clinical outcomes (e.g., mortality, sepsis, necrotizing enterocolitis, length of stay) were analyzed, with NICUs compared using indirect standardization.
Main Results:
- The study included 25,669 MLPIs, representing 17% of all MLPIs born in Canada during the period.
- Significant variations were observed between NICUs in all measured care practices and clinical outcomes.
- Common practices included deferred cord clamping (45%), noninvasive respiratory support (47%), and antibiotic use (40%), with low rates of mortality and major morbidities (<1%).
Conclusions:
- There are substantial variations in care practices and clinical outcomes for moderate and late preterm infants across Canadian NICUs.
- Standardization of process and outcome quality measures is essential for benchmarking.
- Facilitating system-wide improvements in the care of MLPIs is achievable through standardized quality measures and research.
