Neonatal Medicine, Kaiser Permanente, Panorama City, CA, United States; Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States.
Dept of Pediatrics and Mathematics and Statistics, University of Vermont, Burlington, VT, United States; Vermont Oxford Network, Burlington, VT, United States.
Semin Perinatol. 2021 Apr;45(3):151395. doi: 10.1016/j.semperi.2021.151395. Epub 2021 Jan 23.
Although neonatal intensive unit (NICU) care is envisioned as the care of very immature infants, more than 95% of births and 80% of NICU admissions are of more mature newborns-infants born at 34 or more weeks' gestation. In spite of the size of this population there are important gaps in the understanding of their needs and optimal management as reflected by remarkably large unexplained variation in their care. The goal of this article is to describe what is known about the more mature, higher birth weight newborn population's use of NICU care and highlight important gaps in knowledge and obstacles to research. Research priorities are identified: including (1) the need for birth population based rather than NICU based studies, and (2) population specific data elements. Summary: More mature newborns-infants of 34 or more weeks' gestation-account for most NICU admissions. There are large gaps in the understanding of their needs and optimal management as reflected by large unexplained variation in their care. We enumerate these gaps in current knowledge and suggest research priorities to address them.
虽然新生儿重症监护病房（NICU）的设想是为非常不成熟的婴儿提供护理，但超过 95%的分娩和 80%的 NICU 入院是为了更成熟的新生儿——出生时胎龄为 34 周或以上的婴儿。尽管这一人群数量庞大，但他们的需求和最佳管理仍存在重要的理解空白，这反映在他们的护理中存在着大量无法解释的巨大差异。本文的目的是描述在更成熟、更高出生体重的新生儿人群中，NICU 护理的使用情况，并强调知识空白和研究障碍。确定了研究重点：包括（1）需要基于出生人群的研究，而不是基于 NICU 的研究，以及（2）特定人群的数据元素。总结：胎龄为 34 周或以上的更成熟的新生儿——占 NICU 入院人数的大多数。他们的需求和最佳管理仍存在重要的理解空白，这反映在他们的护理中存在着大量无法解释的巨大差异。我们列举了当前知识中的这些差距，并提出了研究重点以解决这些差距。
