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Pediatrics. 2010 Aug;126(2):222-31. doi: 10.1542/peds.2010-0456. Epub 2010 Jul 19.

Impact of timing of birth and resident duty-hour restrictions on outcomes for small preterm infants.

Collaborators (200)

Jobe AH, Wright LL, Johnson KJ, Fanaroff AA, Newman NS, Friedman HG, Siner BS, Wilson-Costello DE, Tyson JE, Kennedy KA, Evans PW, Akpa EG, Alaniz N, Cluff PA, Franco CI, Lis AE, Martin S, Simmons MC, McDavid GE, Tate PL, Bradt PJ, Dieterich S, Major-Kincade T, Morris BH, Reddoch S, Whitely LL, Bara R, Muran G, Goldston L, Johnson YR, Pappas A, Kennedy D, Wheeler R, Bauer CR, Duara S, Everett-Thomas R, Calejo M, Diaz AN, Frade Eguaras SM, Gideon YC, Hiriart-Fajardo S, Ann Londono AL, Mathews EO, Buchter S, Bishop M, Seabrook I, Hale EC, Adams-Chapman I, Carter S, Dinkins E, Miller J, LaRossa MM, Smikle G, Donovan EF, Alexander B, Bridges K, Cathy Grisby C, Mersmann MW, Mincey HL, Hessling J, Gratton TL, Steichen JJ, Poindexter BB, Lemons JA, Appel DD, Herron DE, Miller LC, Hooper R, Bohnke LG, Bull M, Cook AB, Dusick AM, Eaken G, Kardatzke D, Minnich HM, Richard L, Ehrenkranz RA, Gettner P, Konstantino M, Poulsen J, Taft J, Close N, Romano E, Williams J, Stevenson DK, Van Meurs KP, Hintz SR, Ball MB, DeBattista AM, Baran JM, Bond LE, Brudos GK, Lee-Ancajas JC, Pyle RP, St John NH, Adams MM, Kohn JG, Sivakumar D, Oh W, Hensman AM, Alksninis B, Cashore WJ, Gargus RA, Lainwala S, Leach TM, Leonard MR, Mehta K, Moore JR, Noel L, Stephens BE, Walden RV, Vohr BR, Watson VE, Collins MV, Cosby SS, Biasini FJ, Chopko SA, Moses M, Nelson KG, Peralta-Carcelen M, Phillips VA, Rector RV, Whitley S, Finer NN, Rasmussen MR, Wozniak PR, Arnell K, Bridge R, Demetrio C, Goodmar J, Henderson C, Rich W, Barbieri-Welge R, Ben-Tall A, Fuller MG, Ito E, Lukasik M, Pontillo D, Posin D, Runyan C, Vaucher YE, Wilkes J, Zlotnik P, Goldberg RN, Cotten CM, Auten KJ, Goldstein RE, Gustafson KE, Lohmeyer MB, Malcolm WF, O'Shea TM, Peters NJ, Allred D, Korinne Chiu K, Dillard RG, Goldstein DJ, Halfond R, Heller C, Hounshell G, Jackson BG, Morris MW, Peterson C, Waldrep EL, Phelps DL, Reubens LJ, Rowan M, Burnell EL, Johnson J, Hust D, Jensen RL, Kushner E, Merzbach J, Myers GJ, Yost K, Zwetsch L, Rosenfeld CR, Salhab WA, Hensley G, Madison S, Miller NA, Martin M, Allen J, Wilder K, Guzman A, Broyles R, Heyne RJ, Adams SS, Boatman CT, Dooley C, Heyne E, Hickman JF, Madden LA, Morgan JS, Poole WK, Hastings BK, Huitema C, McClure EM, Auman JO, Zaterka-Baxter KM, Newman JE.

Author information

1
Department of Pediatrics, University of Iowa, Iowa City, IA 52242, USA. edward-bell@uiowa.edu

Abstract

OBJECTIVE:

The goal was to examine the impact of birth at night, on the weekend, and during July or August (the first months of the academic year) and the impact of resident duty-hour restrictions on mortality and morbidity rates for very low birth weight infants.

METHODS:

Outcomes were analyzed for 11,137 infants with birth weights of 501 to 1250 g who were enrolled in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network registry in 2001-2005. Approximately one-half were born before the introduction of resident duty-hour restrictions in 2003. Follow-up assessments at 18 to 22 months were completed for 4508 infants. Mortality rate, short-term morbidities, and neurodevelopmental outcome were examined with respect to the timing of birth.

RESULTS:

There was no effect of the timing of birth on mortality rate and no impact on the risks of short-term morbidities except that the risk of retinopathy of prematurity (stage > or =2) was higher after the introduction of duty-hour restrictions and the risk of retinopathy of prematurity requiring operative treatment was lower for infants born during the late night than during the day. There was no impact of the timing of birth on neurodevelopmental outcome except that the risk of hearing impairment or death was slightly lower among infants born in July or August.

CONCLUSION:

In this network, the timing of birth had little effect on the risks of death and morbidity for very low birth weight infants, which suggests that staffing patterns were adequate to provide consistent care.

PMID:
20643715
PMCID:
PMC2924191
DOI:
10.1542/peds.2010-0456
[Indexed for MEDLINE]
Free PMC Article

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