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Lodha A, Brown N, Soraisham A, et al. Twenty-four-hour in-house neonatologist coverage and long-term neurodevelopmental outcomes of preterm infants. Paediatr Child Health. 2017;22(5):249-254doi: 10.1093/pch/pxx051.
Lodha, A., Brown, N., Soraisham, A., Amin, H., Tang, S., & Singhal, N. (2017). Twenty-four-hour in-house neonatologist coverage and long-term neurodevelopmental outcomes of preterm infants. Paediatrics & child health, 22(5), 249-254. https://doi.org/10.1093/pch/pxx051
Lodha, A, et al. "Twenty-four-hour in-house neonatologist coverage and long-term neurodevelopmental outcomes of preterm infants." Paediatrics & child health vol. 22,5 (2017): 249-254. doi: https://doi.org/10.1093/pch/pxx051
Lodha A, Brown N, Soraisham A, Amin H, Tang S, Singhal N. Twenty-four-hour in-house neonatologist coverage and long-term neurodevelopmental outcomes of preterm infants. Paediatr Child Health. 2017 Aug;22(5):249-254. doi: 10.1093/pch/pxx051. Epub 2017 May 05. PMID: 29479228; PMCID: PMC5804586.
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Paediatr Child Health. 2017 Aug;22(5):249-254. doi: 10.1093/pch/pxx051. Epub 2017 May 05.

Twenty-four-hour in-house neonatologist coverage and long-term neurodevelopmental outcomes of preterm infants.

Paediatrics & child health

A Lodha, N Brown, A Soraisham, H Amin, S Tang, N Singhal

Affiliations

  1. Department of Pediatrics, University of Calgary, Calgary, Alberta.
  2. Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta.
  3. Department of Community Health Sciences, University of Calgary, Calgary, Alberta.
  4. Alberta Health Services, Calgary, Alberta.

PMID: 29479228 PMCID: PMC5804586 DOI: 10.1093/pch/pxx051

Abstract

OBJECTIVES: To compare short- and long-term neurodevelopmental outcomes at 3 years of corrected age of preterm infants cared for by 24-hour in-house staff neonatologists and those cared for by staff neonatologists during daytime only.

METHODS: Retrospective analysis of prospectively collected follow-up data on all nonanomalous preterm infants from 1998 to 2004 excluding year 2001 as a washout period. Infants were divided into two groups based on care provided by staff neonatologists: 24-hour in-house coverage (24-hour coverage 1998-2000) and daytime coverage (day coverage 2002-2004). Short- and long-term outcomes were compared.

RESULTS: A total of 387 (78%) of the screened infants were included. Twenty-four-hour coverage (n=179) and day coverage (n=208) groups had a median birth weight (BW) of 875 g (range 470-1250) and 922 g (480-1530; P=0.028), respectively, and both had a median gestational age of 27 weeks. In the day coverage group, a smaller proportion of mothers had chorioamnionitis (20% vs. 30%; P=0.025), received less antibiotics (62% vs. 73%; P=0.023), and infants had fewer cases of confirmed sepsis (14% vs. 23%; P=0.022). In the day coverage group, a larger number of infants had respiratory distress syndrome (87% vs. 77%; P=0.011) and required prolonged mechanical ventilation (median 31 vs. 21 days; P=0.002). The incidence of major neurodevelopmental impairment was not significantly different between the two groups (odds ratio 0.76; 95% confidence interval 0.34-1.65).

CONCLUSIONS: Duration of mechanical ventilation was reduced with 24-hour in-house coverage by staff neonatologists. However, 24-hour coverage was not associated with any difference in neurodevelopmental (ND) outcomes at 3-year corrected age.

Keywords: 24-hour in-house coverage; Neonatal intensive care unit; Neurodevelopmental outcomes; Preterm infants.

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