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Clinical deterioration during neonatal transport in California.

CPQCC Publication
TitleClinical deterioration during neonatal transport in California.
Publication TypeJournal Article
Year of Publication2020
AuthorsPai VV, Kan P, Gould JB, Hackel A, Lee HC
JournalJ Perinatol
Volume40
Issue3
Pagination377-384
Date Published2020 03
ISSN1476-5543
KeywordsAdult, California, Clinical Deterioration, Congenital Abnormalities, Critical Illness, Female, Gestational Age, Humans, Infant, Newborn, Infant, Newborn, Diseases, Infant, Premature, Male, Maternal Age, Regression Analysis, Risk Factors, Time Factors, Transportation of Patients, Young Adult
Abstract

OBJECTIVE: Identify clinical factors, transport characteristics and transport time intervals associated with clinical deterioration during neonatal transport in California.

STUDY DESIGN: Population-based database was used to evaluate 47,794 infants transported before 7 days after birth from 2007 to 2016. Log binomial regression was used to estimate relative risks.

RESULTS: 30.8% of infants had clinical deterioration. Clinical deterioration was associated with prematurity, delivery room resuscitation, severe birth defects, emergent transports, transports by helicopter and requests for delivery room attendance. When evaluating transport time intervals, time required for evaluation by the transport team was associated with increased risk of clinical deterioration. Modifiable transport intervals were not associated with increased risk.

CONCLUSION: Our results suggest that high-risk infants are more likely to be unstable during transport. Coordination and timing of neonatal transport in California appears to be effective and does not seem to contribute to clinical deterioration despite variation in the duration of these processes.

DOI10.1038/s41372-019-0488-5
Alternate JournalJ Perinatol
PubMed ID31488902
PubMed Central IDPMC7223687