Kelly L E, Shah P S, Håkansson S, Kusuda S, Adams M, Lee S K, Sjörs G, Vento M, Rusconi F, Lehtonen L, Reichman B, Darlow B A, Lui K, Feliciano L S, Gagliardi L, Bassler D, Modi N
Maternal-Infant Care Research Centre, Mount Sinai Hospital, 700 University Avenue, Toronto, ON, Canada.
Department of Pediatrics, Mount Sinai Hospital and University of Toronto, 600 University Avenue, Toronto, ON, Canada.
J Perinatol. 2017 Jul;37(7):762-768. doi: 10.1038/jp.2017.45. Epub 2017 Apr 6.
To explore population characteristics, organization of health services and comparability of available information for very low birth weight or very preterm neonates born before 32 weeks' gestation in 11 high-income countries contributing data to the International Network for Evaluating Outcomes of Neonates (iNeo).
We obtained population characteristics from public domain sources, conducted a survey of organization of maternal and neonatal health services and evaluated the comparability of data contributed to the iNeo collaboration from Australia, Canada, Finland, Israel, Italy, Japan, New Zealand, Spain, Sweden, Switzerland and UK.
All countries have nationally funded maternal/neonatal health care with >90% of women receiving prenatal care. Preterm birth rate, maternal age, and neonatal and infant mortality rates were relatively similar across countries. Most (50 to >95%) between-hospital transports of neonates born at non-tertiary units were conducted by designated transport teams; 72% (8/11 countries) had designated transfer and 63% (7/11 countries) mandate the presence of a physician. The capacity of 'step-down' units varied between countries, with capacity for respiratory care available in <10% to >75% of units. Heterogeneity in data collection processes for benchmarking and quality improvement activities were identified.
Comparability of healthcare outcomes for very preterm low birth weight neonates between countries requires an evaluation of differences in population coverage, healthcare services and meta-data.
探讨11个高收入国家中妊娠32周前出生的极低出生体重或极早产儿的人口特征、卫生服务组织情况以及现有信息的可比性，这些国家为国际新生儿结局评估网络（iNeo）提供数据。
我们从公共领域来源获取人口特征，对孕产妇和新生儿卫生服务组织情况进行调查，并评估澳大利亚、加拿大、芬兰、以色列、意大利、日本、新西兰、西班牙、瑞典、瑞士和英国向iNeo合作项目提供的数据的可比性。
所有国家都有国家资助的孕产妇/新生儿医疗保健，超过90%的妇女接受产前护理。各国的早产率、产妇年龄以及新生儿和婴儿死亡率相对相似。大多数（50%至超过95%）在非三级单位出生的新生儿的院际转运由指定的转运团队进行；72%（8/11个国家）有指定的转运安排，63%（7/11个国家）要求有医生在场。“降级”单位的能力因国家而异，具备呼吸护理能力的单位比例在不到10%至超过75%之间。确定了用于基准测试和质量改进活动的数据收集过程中的异质性。
各国之间极低出生体重极早产儿的医疗保健结局的可比性需要评估人口覆盖范围、医疗服务和元数据方面的差异。
