HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Richardson, D K Articles by McCormick, M C Search for Related Content PubMed PubMed Citation Articles by Richardson, D K Articles by McCormick, M C

Perinatal risk and severity of illness in newborns at 6 neonatal intensive care units.

D K Richardson, B L Shah, I D Frantz, 3rd, F Bednarek, L P Rubin and M C McCormick

Joint Program in Neonatology (Beth Israel Deaconess Medical Center, Brigham and Women's Hospital, and Children's Hospital), Harvard Medical School, Boston, MA 02215, USA. richardson@neonatology.bidmc.harvard.edu

OBJECTIVES: This multisite study sought to identify (1) any differences in admission risk (defined by gestational age and illness severity) among neonatal intensive care units (NICUs) and (2) obstetric antecedents of newborn illness severity. METHODS: Data on 1476 babies born at a gestational age of less than 32 weeks in 6 perinatal centers were abstracted prospectively. Newborn illness severity was measured with the Score for Neonatal Acute Physiology. Regression models were constructed to predict scores as a function of perinatal risk factors. RESULTS: The sites differed by several obstetric case-mix characteristics. Of these, only gestational age, small for gestational age. White race, and severe congenital anomalies were associated with higher scores. Antenatal corticosteroids, low Apgar scores, and neonatal hypothermia also affected illness severity. At 2 sites, higher mean severity could not be explained by case mix. CONCLUSIONS: Obstetric events and perinatal practices affect newborn illness severity. These risk factors differ among perinatal centers and are associated with elevated illness severity at some sites. Outcomes of NICU care may be affected by antecedent events and perinatal practices.

This article has been cited by other articles:

				J. Profit, M. C. McCormick, G. J. Escobar, D. K. Richardson, Z. Zheng, K. Coleman-Phox, R. Roberts, and J. A.F. Zupancic Neonatal Intensive Care Unit Census Influences Discharge of Moderately Preterm Infants Pediatrics, February 1, 2007; 119(2): 314 - 319. [Abstract] [Full Text] [PDF]

				Follow-up Care of High-Risk Infants Pediatrics, November 1, 2004; 114(5/S1): 1377 - 1397. [Abstract] [Full Text] [PDF]

				B. R. Vohr, L. L. Wright, A. M. Dusick, R. Perritt, W. K. Poole, J. E. Tyson, J. J. Steichen, C. R. Bauer, D. E. Wilson-Costello, L. C. Mayes, et al. Center Differences and Outcomes of Extremely Low Birth Weight Infants Pediatrics, April 1, 2004; 113(4): 781 - 789. [Abstract] [Full Text] [PDF]

				L. R. Blackmon The Role of the Hospital of Birth on Survival of Extremely Low-birthweight, Extremely Preterm Infants NeoReviews, June 1, 2003; 4(6): e147 - 152. [Full Text] [PDF]

				I. E. Olsen, D. K. Richardson, C. H. Schmid, L. M. Ausman, and J. T. Dwyer Intersite Differences in Weight Growth Velocity of Extremely Premature Infants Pediatrics, December 1, 2002; 110(6): 1125 - 1132. [Abstract] [Full Text] [PDF]

				W. Meadow, L. Frain, Y. Ren, G. Lee, S. Soneji, and J. Lantos Serial Assessment of Mortality in the Neonatal Intensive Care Unit by Algorithm and Intuition: Certainty, Uncertainty, and Informed Consent Pediatrics, May 1, 2002; 109(5): 878 - 886. [Abstract] [Full Text] [PDF]

				A. Wilson, M. N. Gardner, M. A. Armstrong, B. F. Folck, and G. J. Escobar Neonatal Assisted Ventilation: Predictors, Frequency, and Duration in a Mature Managed Care Organization Pediatrics, April 1, 2000; 105(4): 822 - 830. [Abstract] [Full Text]

				International Neonatal Network, S. N. Consultants, and N. C. S. Group Risk adjusted and population based studies of the outcome for high risk infants in Scotland and Australia Arch. Dis. Child. Fetal Neonatal Ed., March 1, 2000; 82(2): 118F - 123. [Abstract] [Full Text]