Journal
JOURNAL OF KOREAN MEDICAL SCIENCE
Volume 36, Issue 13, Pages -Publisher
KOREAN ACAD MEDICAL SCIENCES
DOI: 10.3346/jkms.2021.36.e86
Keywords
Neonatal Mortality; Preterm Infants; Neonatal Intensive Care; Quality of Health Care; After-hours Care
Categories
Funding
- Korea National Institute of Health [2019 ER7103 02]
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This study analyzed data of 3,220 infants born in Korea between 2013-2017, weighing <1,000g and born at 23-34 weeks. It found that in certain neonatal intensive care units, infants born during off-hours had a higher early mortality rate. Further efforts to improve overall NICU quality are needed to address this issue.
Background: Although the overall quality of high-risk neonatal care has improved recently, there is still concern about a difference in the quality of care when comparing off-hour births and regular-hour births. Moreover, there are no data in Korea regarding the impact of time of birth on mortality and morbidities in preterm infants. Methods: A total of 3,220 infants weighing < 1,000 g and born at 23-34 weeks in 2013-2017 were analyzed based on the Korean Neonatal Network data. Mortality and major morbidities were analyzed using logistic regression according to time of birth during off-hours (nighttime, weekend, and holiday) and regular hours. The institutes were sub-grouped into hospital group I and hospital group II based on the neonatal intensive care unit (NICU) care level defined by the mortality rates of < 50% and 2 50%, respectively, in infants born at 23-24 weeks' gestation. Results: The number of births during regular hours and off-hours was similar. In the total population and hospital group I, off-hour births were not associated with increased neonatal mortality and morbidities. However, in hospital group II, increased early mortality was found in the off-hour births when compared to regular-hour births. Conclusion: Efforts to improve the overall quality of NICU are required to lower the early mortality rate in off-hour births. Also, other sensitive indexes for the evaluation of quality of NICU care should be further studied.
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