Marlow N, Chiswick M L
North Western Regional Perinatal Centre, St Mary's Hospital, Manchester.
Arch Dis Child. 1988 Sep;63(9):1069-74. doi: 10.1136/adc.63.9.1069.
From 1976 to 1980, 1034 children who had weighed less than 2001 g at birth were cared for at the North Western regional neonatal intensive care unit. Of these, 315 babies were neonatal referrals and 91 were born in the unit after antenatal transfer from their district hospital. Significantly fewer of the babies referred as neonates survived (n = 167, 53%) compared with 67 of the antenatal referrals (74%), and 490 of those born in the unit (78%). They also had a higher incidence of major handicaps (24 of 167, 14%) compared with six of 67 (9%) of the antenatal referrals and 35 of 490 (7%) of those born in the unit. To control for selection bias among neonatal referrals, the outcome of ventilated neonatal referrals was compared with that of ventilated babies born in the unit. The two groups were comparable for the incidence of a wide range of neonatal complications. No differences in rates of survival or handicap were found. We conclude that sick babies transferred after birth to regional neonatal intensive care units have similar short and long term outcomes to sick babies born in regional units.
1976年至1980年期间，西北区域新生儿重症监护病房照料了1034名出生时体重不足2001克的儿童。其中，315名婴儿是新生儿转诊而来，91名是在产前从地区医院转至该病房后出生的。与产前转诊的婴儿（74%，67例存活）和在该病房出生的婴儿（78%，490例存活）相比，以新生儿身份转诊的婴儿存活者明显较少（167例，53%）。他们的重度残疾发生率也较高（167例中有24例，14%），而产前转诊的婴儿中67例有6例（9%），在该病房出生的婴儿中490例有35例（7%）。为了控制新生儿转诊中的选择偏倚，将接受通气治疗的新生儿转诊病例的结局与在该病房出生的接受通气治疗的婴儿的结局进行了比较。两组在一系列新生儿并发症的发生率方面具有可比性。在存活率或残疾率方面未发现差异。我们得出结论，出生后转至区域新生儿重症监护病房的患病婴儿与在区域病房出生的患病婴儿具有相似的短期和长期结局。
