Potential risk modifiers for severe intraventricular hemorrhage in very low birthweight infants requiring transport.
The Journal of Maternal-Fetal & Neonatal Medicine · 2020-09-01 · Observational study
Abstract
BACKGROUND: Very low birthweight (VLBW) infants must undergo transport when born at a facility unequipped for their care. Previous research suggests an increased risk for intraventricular hemorrhage (IVH) associated with transport. It is unknown whether logistical aspects of transport, particularly mode and distance, or skill level of the resuscitation team are drivers of risk. OBJECTIVE: To determine if the transport vehicle, distance traveled, or absence of advanced resuscitation team increased risk for severe IVH in outborn VLBW infants. DESIGN/METHODS: Outborn VLBW infants, transported by specialized team via helicopter or ambulance to a Level IV NICU, were included; inborn VLBW infants served as controls. Infants transported >24 h after birth, by referring center's team, or without head ultrasound were excluded. Baseline clinical data were collected along with IVH grade, transport vehicle, distance traveled, and skill of resuscitation team. RESULTS: Two hundred and ninety-three outborn were matched to 293 inborn infants. Outborn infants had increased incidence of severe IVH even when controlling for antenatal steroids, race, delivery method, and surfactant use (17% vs. 11%, OR = 1.6, 95% CI = 1.1-2.7). Despite this increased incidence, severe IVH was not associated with transport vehicle (p = .90; OR = 0.76, 95% CI = 0.34-1.7), distance traveled (p = .13; OR 0.84, 95% CI = 0.60-1.2), or skill of resuscitation team (p = .18; OR = 0.49, 95% CI = 0.21-1.1). CONCLUSION: Compared to inborn, outborn infants had increased risk of severe IVH. Transport vehicle, distance traveled, and the skill of resuscitation team did not significantly impact risk.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Helicopter & air ambulance · Interfacility & critical care transport · Neonates
Related articles
- Amplitude-Integrated EEG in Infants at Risk of Hypoxic-Ischemic Encephalopathy: A Feasibility Study in Road and Air Transport in Western Australia. (J Vis Exp, 2024)
- Transport of extremely low birth weight neonates for persistent ductus arteriosus closure in the catheterization lab. (Congenit Heart Dis, 2019)
- Safety, speed, and effectiveness of air transportation for neonates. (Pediatr Int, 2021)
- Hospital survival upon discharge of ill-neonates transported by ground or air ambulance to a tertiary center. (J Pediatr (Rio J), 2016)
- Interhospital Transport of Infants on Bubble Continuous Positive Airway Pressure via Ground and Air. (Air Med J, 2020)
- The Physiological Impact of Neonatal Air Transport: A Review of The Literature. (Air Med J, 2025)