Presence of neonatal intensive care services at birth hospital and early intervention enrollment in infants ≤1500 g

Semsa Gogcu; David Aboudi; Jordan Kase; Edmund LaGamma; Heather Lynn Brumberg

doi:10.1515/jpm-2019-0393

Article

Presence of neonatal intensive care services at birth hospital and early intervention enrollment in infants ≤1500 g

Semsa Gogcu , David Aboudi , Jordan Kase , Edmund LaGamma and Heather Lynn Brumberg

Published/Copyright: April 9, 2020

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From the journal Journal of Perinatal Medicine Volume 48 Issue 4

Abstract

Objective

To determine whether the receipt of therapeutic services of very-low-birth-weight (VLBW; ≤1500 g) neonates inadvertently delivered at community Level 2 and 3 neonatal intensive care units (NICUs) compared with those born at a well-baby nursery (WBN; Level 1) differed.

Methods

This is a retrospective study of neonates who were born at Level 1 (WBN), 2, 3, and 4 NICUs and discharged from a Level 4 hospital (n = 529). All infants were evaluated at the Regional Neonatal Follow-up Program at 12 ± 1 months corrected gestational age (CA) and assessed for use of therapeutic services including: early intervention (EI), occupational therapy (OT), physical therapy (PT), speech therapy (ST), and special education (SE).

Results

Compared to infants born at community Level 2 and 3 NICU hospitals, those outborn at a community Level 1 WBN had significantly higher utilization of EI (90% vs. 62%) and PT (83% vs. 61%) at 12 months CA. This association persisted when controlling for covariates. Infants who required EI had significantly lower Bayley-III cognitive scores at 3 years of age.

Conclusion

VLBW infants outborn at WBN (Level 1) hospitals required more outpatient therapeutic services than those born at hospitals with NICU facilities. These results suggest that delivering at the appropriate community hospital level of care might be advantageous for long-term outcomes.

Keywords: early intervention; neonatal intensive care unit; outborn; regionalization; very-low-birth-weight infant

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
Conflicts of interest: The authors have no conflicts of interest relevant to this article to disclose.
Clinical trials registration: Not Applicable.

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Received: 2019-10-23

Accepted: 2020-03-09

Published Online: 2020-04-09

Published in Print: 2020-04-28

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Articles in the same Issue

https://doi.org/10.1515/jpm-2019-0393

Keywords for this article

early intervention; neonatal intensive care unit; outborn; regionalization; very-low-birth-weight infant