Trulsen Lene Nymo, Hansen Lisa Gullhav, Songstad Nils Thomas, Lang Astri, Klingenberg Claus
Department of Paediatrics and Adolescent Medicine, University Hospital of North Norway, Tromsø, Norway.
Research Group for Child and Adolescent Health, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway.
Front Pediatr. 2025 Jul 1;13:1594729. doi: 10.3389/fped.2025.1594729. eCollection 2025.
Regionalized centralization of moderate and high-risk pregnancies is essential, but a well-organized postnatal transport service is equally important. This study evaluates the overall activity and clinical outcomes of the neonatal air transport team (NATT) at the University Hospital of North Norway (UNN) in Tromsø, covering a large catchment area in the Arctic region of Norway.
Medical data from all neonatal air transports between the years 1994-2023 were recorded prospectively. Body temperature, blood glucose and blood gas within 3-6 h after arrival at UNN were assessed from medical files retrospectively. To assess temporal changes, we compared data between 1994 and 2008 (Period 1) and 2009-2023 (Period 2).
A total of 882 acute transports were included. Of these, 655 (74.3%) were referrals to the tertiary neonatal unit at UNN and 227 (25.7%) transfers to national surgical centers. Most transports (61.5%) were by fixed wing aircrafts. The proportion of infants transported due to congenital heart defects (CHD), prematurity and asphyxia was lower in Period 2. When comparing Period 1 and 2, upon arrival we found similar rates of hypothermia (9.8% vs. 6.7%, = 0.17) and hypercapnia (17.3% vs. 15.3%, = 0.55), but decreasing rates of hypocapnia (6.7% vs. 2.5%, = 0.014) and hypoglycemia (10.8% vs. 2.3%, = 0.001). There were low rates of outborn very low birth weight (VLBW) infants (<1,500 g) in both periods; 4.3% and 3.1%. However, severe IVH was observed in 6/29 (20.7%) outborn VLBW-infants vs. only 21/356 (5.9%) inborn VLBW-infants in the last 15-year period.
Decreasing rates of transport due to prematurity and CHDs is probably secondary to improved perinatal care. Rates of hypoglycemia and hypocapnia improved in the second 15-year period, but further focus on improvements in both temperature and CO control is warranted. Acute transport of VLBW-infants is associated with a markedly increased risk of severe IVH. In-utero transfer of women with threatened preterm birth to a tertiary perinatal center is therefore paramount.
中高危妊娠的区域集中化至关重要，但组织良好的产后转运服务同样重要。本研究评估了挪威特罗姆瑟北挪威大学医院（UNN）新生儿航空转运团队（NATT）的整体活动及临床结局，该团队覆盖挪威北极地区的大片集水区。
前瞻性记录1994年至2023年间所有新生儿航空转运的医疗数据。回顾医疗档案评估抵达UNN后3 - 6小时内的体温、血糖和血气情况。为评估时间变化，我们比较了1994年至2008年（第1阶段）和2009年至2023年（第2阶段）的数据。
共纳入882例急性转运病例。其中，655例（74.3%）转诊至UNN的三级新生儿病房，227例（25.7%）转至国家外科中心。大多数转运（61.5%）通过固定翼飞机进行。第2阶段因先天性心脏病（CHD）、早产和窒息而转运的婴儿比例较低。比较第1阶段和第2阶段，抵达时我们发现体温过低发生率相似（9.8%对6.7%，P = 0.17）和高碳酸血症发生率相似（17.3%对15.3%，P = 0.55），但低碳酸血症发生率下降（6.7%对2.5%，P = 0.014）和低血糖发生率下降（10.8%对2.3%，P = 0.001）。两个时期出生体重极低（VLBW）婴儿（<1500g）的院外发生率均较低；分别为4.3%和3.1%。然而，在过去15年中，6/29例（20.7%）院外VLBW婴儿发生严重颅内出血（IVH），而同期仅21/356例（5.9%）院内VLBW婴儿发生严重IVH。
早产和CHD导致的转运率下降可能归因于围产期护理的改善。在第二个15年期间，低血糖和低碳酸血症发生率有所改善，但仍需进一步关注体温和二氧化碳控制的改善。VLBW婴儿的急性转运与严重IVH风险显著增加相关。因此，将有早产风险的孕妇在宫内转运至三级围产期中心至关重要。
