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Impact of extremely immature infants on neonatal services
S Bohin1, E S Draper, D J Field
1Department of Epidemiology and Public Health, University of Leicester.
Insights
The UK
Area of Science:
- Neonatalogy and Perinatal Medicine
- Pediatric Critical Care
Background:
- Neonatal services face significant demands from very premature infants.
- The UK's approach to extremely preterm births requires examination.
Purpose of the Study:
- To assess the resource utilization and outcomes for extremely premature infants in the UK.
- To evaluate the impact of very immature infants on neonatal care services.
Main Methods:
- Retrospective analysis of neonatal data from the Trent Health Region (1991-1993).
- Inclusion criteria: infants born <1501g or <32 weeks gestation.
- Data collected: length of stay, ventilation duration, survival rates.
Main Results:
- Survival was extremely low for infants born before 24 weeks gestation (1/49), with 75% receiving ventilation.
- Most infants born before 24 weeks died within 48 hours.
- Infants <24 weeks gestation accounted for 1.5% of ventilated infants and 2.14% of regional ventilator days.
Conclusions:
- The UK employs a conservative management strategy for infants born before 24 weeks gestation.
- Resource allocation for this extremely preterm group appears limited, reflecting policy.
- The findings suggest a cautious approach to intensive neonatal care for the most immature infants.
Abstract:
The impact of very immature infants on neonatal services was examined within the United Kingdom. The Trent Health Region was used as a geographically defined population. Data were obtained on all infants weighing less than 1501 g at birth and all infants born before 32 weeks gestation between 1991-93. Information relating to length of stay, duration of ventilation, and survival was documented. Only one of 49 infants born before 24 weeks gestation survived. However, 75% of this group were ventilated. Most of the remaining infants died before 48 hours of age. A similar pattern was also seen in infants of 24 and 25 weeks gestation. Infants under 24 weeks gestation comprised 1.5% of all ventilated infants and consumed 2.14% of the total neonatal ventilator days for the region. It is concluded that the United Kingdom operates a conservative policy towards infants born before 24 weeks gestation and as a result resources expended on them are limited.