PDF(Pubmed)
Abstract：
UNASSIGNED: The evidence that risks of morbidity and mortality are higher when very premature newborns are born during the on-call period is inconsistent. This study aimed to assess the impact of this situation among other determinants of outcomes, particularly newborn characteristics and care organization.
UNASSIGNED: Observational study including all infants born < 30 weeks\' gestation in a French tertiary perinatal center between 2007 and 2020. On-call period corresponded to weekdays between 6:30 p.m. and 8:30 a.m., weekends, and public holidays. The primary endpoint was survival without severe morbidity, including grade 3-4 intraventricular hemorrhage (IVH), cystic periventricular leukomalacia, necrotizing enterocolitis, severe bronchopulmonary dysplasia (BPD), and severe retinopathy of prematurity. The relationship between admission and outcome was assessed by an adjusted odds ratio (aOR) on the propensity of being born during on-call period and expressed vs. weekday. Secondary analyses were carried out in extremely preterm newborns (<27 weeks\' gestation), in cases of early death (within 7 days), and before (2007-2013, 51.5% of the cohort) vs. after (2014-2020, 48.5% of the cohort) the implementation of a pediatrician-nurse team dedicated to newborn care in the delivery room.
UNASSIGNED: A total of 1,064 infants [27.9 (26.3; 28.9) weeks, 947 (760; 1,147) g] were included: 668 during the on-call period (63%) and 396 (37%) on weekdays. For infants born on weekdays, survival without severe morbidity was 54.5% and mortality 19.2%. During on-call, these rates were 57.3% [aOR 1.08 (0.84-1.40)] and 18.4% [aOR 0.93 (0.67-1.29)]. Comparable rates of survival without severe morbidity [aOR 1.42 (0.87-2.34)] or mortality [aOR 0.76 (0.47-1.22)] were observed in extremely preterm infants. The early death rate was 6.4% on weekdays vs. 8.2% during on-call [aOR 1.44 (0.84-2.48)]. Implementation of the dedicated team was associated with decreased rates of mortality [aOR 0.57 (0.38, 0.85)] and grade 3-4 IVH [aOR 0.48 (0.30, 0.75)], and an increased rate of severe BPD [aOR 2.16 (1.37, 3.41)], for infants born during on-call.
UNASSIGNED: In this cohort, most births of very premature neonates occurred during the on-call period. A team dedicated to newborn care in the delivery room may have a favorable effect on the outcome of infants born in this situation.
UNASSIGNED: Observational study including all infants born < 30 weeks\' gestation in a French tertiary perinatal center between 2007 and 2020. On-call period corresponded to weekdays between 6:30 p.m. and 8:30 a.m., weekends, and public holidays. The primary endpoint was survival without severe morbidity, including grade 3-4 intraventricular hemorrhage (IVH), cystic periventricular leukomalacia, necrotizing enterocolitis, severe bronchopulmonary dysplasia (BPD), and severe retinopathy of prematurity. The relationship between admission and outcome was assessed by an adjusted odds ratio (aOR) on the propensity of being born during on-call period and expressed vs. weekday. Secondary analyses were carried out in extremely preterm newborns (<27 weeks\' gestation), in cases of early death (within 7 days), and before (2007-2013, 51.5% of the cohort) vs. after (2014-2020, 48.5% of the cohort) the implementation of a pediatrician-nurse team dedicated to newborn care in the delivery room.
UNASSIGNED: A total of 1,064 infants [27.9 (26.3; 28.9) weeks, 947 (760; 1,147) g] were included: 668 during the on-call period (63%) and 396 (37%) on weekdays. For infants born on weekdays, survival without severe morbidity was 54.5% and mortality 19.2%. During on-call, these rates were 57.3% [aOR 1.08 (0.84-1.40)] and 18.4% [aOR 0.93 (0.67-1.29)]. Comparable rates of survival without severe morbidity [aOR 1.42 (0.87-2.34)] or mortality [aOR 0.76 (0.47-1.22)] were observed in extremely preterm infants. The early death rate was 6.4% on weekdays vs. 8.2% during on-call [aOR 1.44 (0.84-2.48)]. Implementation of the dedicated team was associated with decreased rates of mortality [aOR 0.57 (0.38, 0.85)] and grade 3-4 IVH [aOR 0.48 (0.30, 0.75)], and an increased rate of severe BPD [aOR 2.16 (1.37, 3.41)], for infants born during on-call.
UNASSIGNED: In this cohort, most births of very premature neonates occurred during the on-call period. A team dedicated to newborn care in the delivery room may have a favorable effect on the outcome of infants born in this situation.
摘要：
UNASSIGNED：有证据表明，在待命期间出生早产新生儿时，发病率和死亡率的风险更高。这项研究旨在评估这种情况在其他结果决定因素中的影响，特别是新生儿特征和护理组织。
UNASSIGNED：观察性研究包括2007年至2020年在法国三级围产期中心出生<30周的所有婴儿。随叫随到时间对应于工作日下午6:30至上午8:30，周末,和公众假期。主要终点是无严重发病率的生存率，包括3-4级脑室内出血（IVH），囊性脑室周围白质软化，坏死性小肠结肠炎,重度支气管肺发育不良（BPD），和严重的早产儿视网膜病变.入院与结果之间的关系是通过调整后的优势比（aOR）对在通话期间出生的倾向进行评估的，并表示与工作日。二次分析在极早产新生儿（<27周妊娠）进行，在早期死亡（7天内）的情况下，之前（2007-2013年，占队列的51.5%）与在(2014-2020年,队列的48.5%)实施了一个致力于分娩室新生儿护理的儿科医生-护士团队之后.
未经评估：总共1,064名婴儿[27.9（26.3；28.9）周，包括947（760；1,147）g]：待命期间为668（63％），工作日为396（37％）。对于平日出生的婴儿，无严重发病率的生存率为54.5%,死亡率为19.2%.在通话期间,这些比率分别为57.3%[aOR1.08(0.84-1.40)]和18.4%[aOR0.93(0.67-1.29)]。在极度早产儿中观察到无严重发病率[aOR1.42（0.87-2.34）]或死亡率[aOR0.76（0.47-1.22）]的生存率相当。平日的早期死亡率为6.4%，而不是在通话期间为8.2%[aOR1.44（0.84-2.48）]。专门小组的实施与死亡率[aOR0.57（0.38，0.85）]和3-4级IVH[aOR0.48（0.30，0.75）]下降有关，严重BPD的发生率增加[aOR2.16（1.37，3.41）]，对于在待命期间出生的婴儿。
未经评估：在此队列中，大多数早产新生儿的出生发生在待命期间。一个致力于分娩室新生儿护理的团队可能会对在这种情况下出生的婴儿的结局产生有利影响。
UNASSIGNED：观察性研究包括2007年至2020年在法国三级围产期中心出生<30周的所有婴儿。随叫随到时间对应于工作日下午6:30至上午8:30，周末,和公众假期。主要终点是无严重发病率的生存率，包括3-4级脑室内出血（IVH），囊性脑室周围白质软化，坏死性小肠结肠炎,重度支气管肺发育不良（BPD），和严重的早产儿视网膜病变.入院与结果之间的关系是通过调整后的优势比（aOR）对在通话期间出生的倾向进行评估的，并表示与工作日。二次分析在极早产新生儿（<27周妊娠）进行，在早期死亡（7天内）的情况下，之前（2007-2013年，占队列的51.5%）与在(2014-2020年,队列的48.5%)实施了一个致力于分娩室新生儿护理的儿科医生-护士团队之后.
未经评估：总共1,064名婴儿[27.9（26.3；28.9）周，包括947（760；1,147）g]：待命期间为668（63％），工作日为396（37％）。对于平日出生的婴儿，无严重发病率的生存率为54.5%,死亡率为19.2%.在通话期间,这些比率分别为57.3%[aOR1.08(0.84-1.40)]和18.4%[aOR0.93(0.67-1.29)]。在极度早产儿中观察到无严重发病率[aOR1.42（0.87-2.34）]或死亡率[aOR0.76（0.47-1.22）]的生存率相当。平日的早期死亡率为6.4%，而不是在通话期间为8.2%[aOR1.44（0.84-2.48）]。专门小组的实施与死亡率[aOR0.57（0.38，0.85）]和3-4级IVH[aOR0.48（0.30，0.75）]下降有关，严重BPD的发生率增加[aOR2.16（1.37，3.41）]，对于在待命期间出生的婴儿。
未经评估：在此队列中，大多数早产新生儿的出生发生在待命期间。一个致力于分娩室新生儿护理的团队可能会对在这种情况下出生的婴儿的结局产生有利影响。
