新生儿在外院出生与在本院出生的死亡率比较。
Neonatal mortality among outborn versus inborn babies.
机构信息
Department of Pediatrics, Chiayi Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Chiayi, Taiwan.
Center for Quality Management, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
出版信息
Pediatr Neonatol. 2021 Jul;62(4):412-418. doi: 10.1016/j.pedneo.2021.04.001. Epub 2021 Apr 22.
BACKGROUND
Most previous studies reported there were higher survival rates if low birth weight babies were born in tertiary perinatal centers (inborn) than elsewhere (outborn). The objective of this study is to examine whether the number and ratio of outborn babies decrease and the neonatal mortality differs between inborn and outborn babies.
METHODS
We used the pooled data of the Taiwan Clinical Effectiveness Index for the years 2011-2016 obtained from the Joint Commission of Taiwan to study the outborn/inborn number and neonatal mortality rate.
RESULTS
We found that the number of outborn babies did not decrease year by year. The ratio of outborn to total babies was lower in the groups of birth body weight 750-999 g and ≧ 2500 g than the other groups. The neonatal mortality rate in outborns was significantly higher than the inborns in the groups of birth body weight 1000-1499 g, 2000-2499 g and ≧ 2500 g (6.9 ± 2.4 vs. 3.8 ± 0.9, P = 0.009, 2.6 ± 0.6 vs. 0.6 ± 0.3, P = 0.002 and 1.52 ± 0.67 vs. 0.08 ± 0.02, P = 0.002, respectively) in medical centers.
CONCLUSION
Improved maternal transport which promotes in utero transfer of patients may further improve neonatal outcome.
背景
大多数先前的研究报告表明，如果低出生体重儿在三级围产中心（本地出生）出生，其存活率会更高，而不是在其他地方（外地出生）。本研究的目的是检查外地出生婴儿的数量和比例是否减少，以及本地出生和外地出生婴儿的新生儿死亡率是否存在差异。
方法
我们使用了台湾联合委员会从 2011 年至 2016 年获得的台湾临床疗效指数汇总数据，研究了外地出生/本地出生的数量和新生儿死亡率。
结果
我们发现外地出生婴儿的数量并没有逐年减少。出生体重为 750-999g 和≥2500g 的组中外地出生婴儿的比例低于其他组。体重为 1000-1499g、2000-2499g 和≥2500g 的外地出生婴儿的新生儿死亡率明显高于本地出生婴儿（6.9±2.4 vs. 3.8±0.9，P=0.009；2.6±0.6 vs. 0.6±0.3，P=0.002；1.52±0.67 vs. 0.08±0.02，P=0.002）。
结论
改善产妇转运，促进胎儿在宫内转移，可能进一步改善新生儿结局。
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