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The validity of the variable "NICU admission" as an outcome measure for neonatal morbidity: a retrospective study. / Wiegerinck, Melanie M. J.; Danhof, Nora A.; van Kaam, Anton H. et al.
In: Acta obstetricia et gynecologica Scandinavica, Vol. 93, No. 6, 2014, p. 603-609.Research output: Contribution to journal › Article › Academic › peer-review
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TY - JOUR
T1 - The validity of the variable "NICU admission" as an outcome measure for neonatal morbidity: a retrospective study
AU - Wiegerinck, Melanie M. J.
AU - Danhof, Nora A.
AU - van Kaam, Anton H.
AU - Tamminga, Pieter
AU - Mol, Ben Willem J.
PY - 2014
Y1 - 2014
N2 - To determine whether "neonatal intensive care unit (NICU) admission" is a valid surrogate outcome measure to assess neonatal condition in clinical studies. Retrospective study. Tertiary hospital in the Netherlands. Neonates admitted to NICU during a 10-year period. Inclusion was restricted to singletons born beyond 37 weeks of gestation, and admitted to NICU in the first 24 h for delivery-related morbidity. Patient characteristics and admission data were compared for four groups based on the line of care during delivery, i.e. home birth (Ia), midwife-led hospital delivery (Ib), secondary care (II), tertiary care (III). Percentage of neonates/infants that died during NICU admission, diagnosis on admission, treatment received and a Neonatal Therapeutic Intervention Score System (NTISS). We studied 776 newborns (Ia 52, Ib 25, II 160, III 512, 27 unknown). The mortality rate differed significantly (Ia 15%, Ib 12%, II 22%, III 1%, p < 0.01), as did the NTISS morbidity scores at admission [Ia 12.0 (6.0-23.0), Ib 8.5 (6.3-10.0), II 21.0 (15.0-30.0), III 6.0 (4.0-9.0); p < 0.01], diagnosis at admission, received treatment and the duration of admission. The severity of neonatal illness after 37 weeks of gestation differed depending on the line of care in which they were born, with neonates born in secondary care consistently having the highest morbidity, and those born in tertiary care having the lowest. NICU admission should not be used as an outcome measure for neonatal morbidity, specifically not when comparing different birth settings
AB - To determine whether "neonatal intensive care unit (NICU) admission" is a valid surrogate outcome measure to assess neonatal condition in clinical studies. Retrospective study. Tertiary hospital in the Netherlands. Neonates admitted to NICU during a 10-year period. Inclusion was restricted to singletons born beyond 37 weeks of gestation, and admitted to NICU in the first 24 h for delivery-related morbidity. Patient characteristics and admission data were compared for four groups based on the line of care during delivery, i.e. home birth (Ia), midwife-led hospital delivery (Ib), secondary care (II), tertiary care (III). Percentage of neonates/infants that died during NICU admission, diagnosis on admission, treatment received and a Neonatal Therapeutic Intervention Score System (NTISS). We studied 776 newborns (Ia 52, Ib 25, II 160, III 512, 27 unknown). The mortality rate differed significantly (Ia 15%, Ib 12%, II 22%, III 1%, p < 0.01), as did the NTISS morbidity scores at admission [Ia 12.0 (6.0-23.0), Ib 8.5 (6.3-10.0), II 21.0 (15.0-30.0), III 6.0 (4.0-9.0); p < 0.01], diagnosis at admission, received treatment and the duration of admission. The severity of neonatal illness after 37 weeks of gestation differed depending on the line of care in which they were born, with neonates born in secondary care consistently having the highest morbidity, and those born in tertiary care having the lowest. NICU admission should not be used as an outcome measure for neonatal morbidity, specifically not when comparing different birth settings
U2 - 10.1111/aogs.12384
DO - 10.1111/aogs.12384
M3 - Article
C2 - 24666278
VL - 93
SP - 603
EP - 609
JO - Acta obstetricia et gynecologica Scandinavica
JF - Acta obstetricia et gynecologica Scandinavica
SN - 0001-6349
IS - 6
ER -
ID: 2383403