Kreuzhof Julia, Maier Rolf, Döbler Klaus
Kompetenz-Centrum Qualitätssicherung / Qualitätsmanagement, MDK Baden-Württemberg, Stuttgart.
Klinik für Kinder- und Jugendmedizin, Uniklinikum Marburg, Marburg.
Z Geburtshilfe Neonatol. 2020 Feb;224(1):31-37. doi: 10.1055/a-0868-2513. Epub 2019 Apr 17.
In Germany the care of newborn infants is regulated by directives of the Federal Joint Committee. Assignment to the four levels of care, with level 1 being the highest level, is based on maternal risk factors, maternal and fetal diseases, birth weight and gestational age. This article compares birth weight and gestational age limits used in Germany with international regulations.
A manual search of websites of medical societies and regulative bodies in Europe, Northern America and Australia for regulations and guidelines was performed.
Outside of Germany, level 1 is the lowest level of care. 2 to 7 levels are used. In Germany a birth weight<1250 g and a gestational age<29+0 weeks of gestation require treatment at the highest level. Internationally, the assignment to the highest level is most frequently defined by a birth weight of 1250 g or 1500 g. Birth weight is often associated with gestational age. The American Academy of Pediatrics refers to a meta-analysis in which the mortality was significantly lower if preterm infants with less than 1500 g and 32+0 weeks of gestation were born and treated in a highly specialized hospital.
Birth weight and gestational age limits for the assignment of preterm infants to different levels of care are internationally inhomogeneous. Only one guideline provides a scientific justification for the assignment rules.
在德国，新生儿护理由联邦联合委员会的指令进行规范。根据母亲风险因素、母婴疾病、出生体重和孕周将护理分为四个级别，其中一级为最高级别。本文将德国使用的出生体重和孕周限制与国际规定进行比较。
手动搜索欧洲、北美和澳大利亚医学协会及监管机构网站上的法规和指南。
在德国境外，一级是最低护理级别，使用的级别为2至7级。在德国，出生体重<1250g且孕周<29+0周需要最高级别的治疗。在国际上，最高级别护理的分配最常由出生体重1250g或1500g来定义。出生体重通常与孕周相关。美国儿科学会提及一项荟萃分析，其中体重低于1500g且孕周小于32+0周的早产儿在高度专业化医院出生并接受治疗时，死亡率显著降低。
国际上，将早产儿分配到不同护理级别的出生体重和孕周限制并不统一。只有一项指南为分配规则提供了科学依据。
