Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2000 Mar;82(2):F118-23.
doi: 10.1136/fn.82.2.f118.

Risk adjusted and population based studies of the outcome for high risk infants in Scotland and Australia. International Neonatal Network, Scottish Neonatal Consultants, Nurses Collaborative Study Group

N International, S. N. Consultants, N. C. Group
Multicenter Study

Risk adjusted and population based studies of the outcome for high risk infants in Scotland and Australia. International Neonatal Network, Scottish Neonatal Consultants, Nurses Collaborative Study Group

N International et al. Arch Dis Child Fetal Neonatal Ed. 2000 Mar.

Erratum in

  • Arch Dis Child Fetal Neonatal Ed 2000 Sep;83(2):F164

Abstract

Objectives: To compare outcomes of care in selected neonatal intensive care units (NICUs) for very low birthweight (VLBW) or preterm infants in Scotland and Australia (study 1) and perinatal care for all VLBW infants in both countries (study 2).

Design: Study 1: risk adjusted cohort study; study 2: population based cohort study.

Subjects: Study 1: all 2621 infants of < 1500 g birth weight or < 31 weeks' gestation admitted to a volunteer sample of hospitals comprising eight of all 17 Scottish NICUs and six of all 12 tertiary NICUs in New South Wales and Queensland in 1993-1994; study 2: all 5986 infants of 500-1499 g birth weight registered as live born in Scotland and Australia in 1993-1994.

Main outcomes: Study 1: (a) hospital death; (b) death or cerebral damage, each adjusted for gestation and CRIB (clinical risk index for babies); study 2: neonatal (28 day) mortality.

Results: Study 1. Data were obtained for 1628 admissions in six Australian NICUs, 775 in five Scottish tertiary NICUs, and 148 in three Scottish non-tertiary NICUs. Crude hospital death rates were 13%, 22%, and 22% respectively. Risk adjusted hospital mortality was about 50% higher in Scottish than in Australian NICUs (adjusted mortality ratio 1.46, 95% confidence interval (CI) 1.29 to 1.63, p < 0.001). There was no difference in risk adjusted outcomes between Scottish tertiary and non-tertiary NICUs. After risk adjustment, death or cerebral damage was more common in Scottish than Australian NICUs (odds ratio 1.9, 95% CI 1.5 to 2.5). Both these risk adjusted adverse outcomes remained more common in Scottish than Australian NICUs after excluding all infants < 28 weeks' gestation from the comparison. Study 2. Population based neonatal mortality in infants of 500-1499 g was higher in Scotland (20.3%) than Australia (16.6%) (relative risk 1.22, 95% CI 1.08 to 1. 39, p = 0.002). In a post hoc analysis, neonatal mortality was also higher in England and Wales than in Australia.

Conclusions: Study 1: outcome was better in the Australian NICUs. Study 2: perinatal outcome was better in Australia. Both results may be consistent, at least in part, with differences in the organisation and implementation of neonatal care.

PubMed Disclaimer

Comment in

References

    1. Am J Public Health. 1999 Apr;89(4):511-6 - PubMed
    1. Arch Dis Child Fetal Neonatal Ed. 1998 Mar;78(2):F99-104 - PubMed
    1. Arch Dis Child Fetal Neonatal Ed. 1999 Mar;80(2):F111-4 - PubMed
    1. Acta Paediatr. 1998 Feb;87(2):134-5 - PubMed
    1. Radiology. 1983 Sep;148(3):839-43 - PubMed

Publication types