Journal article
The impact of level of neonatal care provision on outcomes for preterm babies born between 27 and 31 weeks of gestation, or with a birth weight between 1000 and 1500 g: a review of the literature
- Abstract:
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Objective There is evidence that birth and care in a maternity service associated with a neonatal intensive care unit (NICU) is associated with improved survival in preterm babies born at <27 weeks of gestation. We conducted a systematic review to address whether similar gains manifested in babies born between 27+0 and 31+6 weeks (hereafter 27 and 31 weeks) of gestation, or in those with a birth weight between 1000 and 1500 g.
Methods We searched Embase, Medline and CINAHL databases for studies comparing outcomes for babies born between 27 and 31 weeks or between 1000 and 1500 g birth weight, based on designation of the neonatal unit where the baby was born or subsequently cared for (NICU vs non-NICU setting). A modified QUIPS (QUality In Prognostic Studies) tool was used to assess quality.
Results Nine studies compared outcomes for babies born between 27 and 31 weeks of gestation and 11 studies compared outcomes for babies born between 1000 and 1500 g birth weight. Heterogeneity in comparator groups, birth locations, gestational age ranges, timescale for mortality reporting, and description of morbidities facilitated a narrative review as opposed to a meta-analysis.
Conclusion Due to paucity of evidence, significant heterogeneity and potential for bias, we were not able to answer our question—does place of birth or care affect outcomes for babies born between 27 and 31 weeks? This supports the need for large-scale research to investigate place of birth and care for babies born in this gestational age range.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, 545.3KB, Terms of use)
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- Publisher copy:
- 10.1136/bmjpo-2019-000583
Authors
Contributors
- Institution:
- University of Oxford
- Division:
- MSD
- Department:
- Nuffield Department of Population Health
- Role:
- Contributor
- Publisher:
- BMJ
- Journal:
- BMJ Paediatrics Open More from this journal
- Volume:
- 4
- Issue:
- 1
- Article number:
- e000583
- Publication date:
- 2020-03-18
- Acceptance date:
- 2020-01-31
- DOI:
- EISSN:
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2399-9772
- Language:
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English
- Keywords:
- Pubs id:
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1100251
- Local pid:
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pubs:1100251
- Deposit date:
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2020-05-13
Terms of use
- Copyright date:
- 2020
- Rights statement:
- © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial.
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