Original ArticlesVariations in intraventricular hemorrhage incidence rates among Canadian neonatal intensive care units☆,☆☆,★
Section snippets
Population
The study population comprised all 19,507 infants admitted to 17 NICUs in the Canadian NICU Network from January 8, 1996, to October 31, 1997. The 17 hospitals, except one, are regional tertiary level referral centers and include 75% of level 3 NICU beds in Canada. The NICUs ranged in size from 9 to 70 beds and had an average of 133 to 1129 admissions annually. The data were collected as part of a larger study of practices and outcomes of NICUs1 across Canada, which had a population of nearly
Results
Of the 19,507 infants admitted to the Canadian NICU Network during the study period, 5126 were <33 completed weeks’ GA at birth and <4 days old at admission. Of these infants, 3806 had neuroimaging performed in the first 2 weeks of life. Neuroimaging reports were available for 89% of all infants <31 weeks’ GA and 58% of all infants between 31 and 32 weeks’ GA. Neuroimaging practices differed significantly between NICUs (range, 63%-100% among infants <33 weeks’ GA). Infants with neuroimaging
Discussion
This study demonstrates a statistically and clinically significant variation in the incidence of diagnosed IVH in premature infants (<33 weeks’ GA) admitted to NICUs. This variation existed across all grades of IVH and all GA categories. Previous reports of variations in the incidence of diagnosed IVH among preterm infants admitted to NICUs did not adjust for variations in patient population. In our study, we found that risk adjustment for baseline population risk factors and SNAP-II resulted
Acknowledgements
Members of the Canadian NICU Network: Shoo K. Lee, MBBS, FRCPC, PhD (Coordinator, Canadian NICU Network; Centre for Community Health and Health Evaluation Research, Vancouver, BC); Wayne Andrews, MD, FRCPC (Charles A. Janeway Child Health Centre, St John’s, NF); Ranjit Baboolal, MBChB, FRCPC (North York Hospital, North York, ON); Jill Boulton, MD, FRCPC (St Joseph’s Health Centre, London, ON; previously Mt Sinai Hospital, Toronto, ON); David Brabyn, MBChB, FRACP, FRCPC (Royal Columbian
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Cited by (136)
Clinical outcomes for babies born between 27 – 31 weeks of gestation: Should they be regarded as a single cohort?
2023, Journal of Neonatal NursingCitation Excerpt :This variation in scanning frequency is based on the inverse correlation gestational age at birth has with risk of IVH (Brouwer et al., 2008; Synnes et al., 2001). Babies born at 27–28 weeks have a 2-fold increased risk of developing intraventricular haemorrhage (IVH) of any grade, compared to those born at 31 weeks (Brouwer et al., 2008; Synnes et al., 2001). Severe IVH (stage III/IV) is three times more common in those born at 27 weeks than 31 weeks.
Intracranial Hemorrhage and 2-Year Neurodevelopmental Outcomes in Infants Born Extremely Preterm
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2017, Seminars in PerinatologyCitation Excerpt :Studies using data from the period of deregionalization also support these findings, showing a 30–75% increase in mortality when infants with a birth weight under 1500 g are delivered at lower level or lower volume hospitals.29,31,36,46–61 There are a limited number of studies that find better outcomes when these deliveries occur in hospitals with higher volume NICUs.51,62–69 These studies also found that outcomes are much better when the case is referred to a hospital with a high-volume, high-level NICU as a maternal referral, or transport.62,63
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A complete list of the members of the Canadian NICU Network appears at the end of this article
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Supported by Grant 40503 and Grant 00152 from the Medical Research Council of Canada. Additional funding was provided by the B.C.’s Children’s Hospital Foundation; Calgary Regional Health Authority; Dalhousie University Neonatal-Perinatal Research Fund; Division of Neonatology, Children’s Hospital of Eastern Ontario; Child Health Program, Health Care Corporation of St John’s; The Neonatology Program, Hospital for Sick Children; Lawson Research Institute; Midland Walwyn Capital Inc; Division of Neonatology, Hamilton Health Sciences Corporation; Mount Sinai Hospital; North York General Hospital Foundation; Saint Joseph’s Health Centre; University of Saskatchewan Neonatal Research Fund; and University of Western Ontario; Women’s College Hospital.
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Reprint requests: Shoo K. Lee, MBBS, FRCPC, PhD, Centre for Community Health and Health Evaluation Research, 4480 Oak St, Room E-414, Vancouver, BC, V6H 3V4 Canada.