Outcomes of Preterm Neonates Transferred Between Tertiary Perinatal Centers

Abstract

Objective: To verify if preterm neonates transferred between tertiary referral centers have worse outcomes than matched untransferred infants.

Design: Cohort study with a historically matched control group.

Setting: Two tertiary-level neonatal ICUs.

Patients: Seventy-five neonates per group.

Interventions: Transfer between tertiary-level neonatal ICUs carried out by a fully equipped transportation team.

Measurements and main results: We measured in-hospital mortality, frequency of intraventricular hemorrhage greater than 2nd grade, periventricular leukomalacia, necrotizing enterocolitis greater than or equal to grade 2, bronchopulmonary dysplasia, composite outcomes (in-hospital mortality/bronchopulmonary dysplasia, in-hospital mortality/intraventricular hemorrhage > 2nd grade, and bronchopulmonary dysplasia/periventricular leukomalacia/intraventricular hemorrhage > 2nd grade), length of neonatal ICU stay, weight at discharge, and time spent on ventilatory support. Seventy-five similar (except for antenatal steroids administration) neonates were enrolled in each cohort. Cohorts did not differ in mortality, bronchopulmonary dysplasia, intraventricular hemorrhage greater than 2nd grade, periventricular leukomalacia, necrotizing enterocolitis greater than or equal to grade 2, any composite outcomes, neonatal ICU stay, weight at discharge, and duration of respiratory support. Results were unchanged adjusting for antenatal steroids.

Conclusions: Neonatal transfer between tertiary-level centers does not impact on clinical outcomes, if performed under optimal conditions.