The Canadian Preterm Birth Network: a study protocol for improving outcomes for preterm infants and their families

Abstract

Background: Preterm birth (birth before 37 wk of gestation) occurs in about 8% of pregnancies in Canada and is associated with high mortality and morbidity rates that substantially affect infants, their families and the health care system. Our overall goal is to create a transdisciplinary platform, the Canadian Preterm Birth Network (CPTBN), where investigators, stakeholders and families will work together to improve childhood outcomes of preterm neonates.

Methods: Our national cohort will include 24 maternal-fetal/obstetrical units, 31 neonatal intensive care units and 26 neonatal follow-up programs across Canada with planned linkages to provincial health information systems. Three broad clusters of projects will be undertaken. Cluster 1 will focus on quality-improvement efforts that use the Evidence-based Practice for Improving Quality method to evaluate information from the CPTBN database and review the current literature, then identify potentially better health care practices and implement identified strategies. Cluster 2 will assess the impact of current practices and practice changes in maternal, perinatal and neonatal care on maternal, neonatal and neurodevelopmental outcomes. Cluster 3 will evaluate the effect of preterm birth on babies, their families and the health care system by integrating CPTBN data, parent feedback, and national and provincial database information in order to identify areas where more parental support is needed, and also generate robust estimates of resource use, cost and cost-effectiveness around preterm neonatal care.

Interpretation: These collaborative efforts will create a flexible, transdisciplinary, evaluable and informative research and quality-improvement platform that supports programs, projects and partnerships focused on improving outcomes of preterm neonates.

Figure 1

Approximate timeline of Canadian Preterm Birth Network research projects. Note: EPIQ = Evidence-based Practice for Improving Quality, KT = knowledge translation, QI = quality improvement.

Figure 2

Map of the Canadian Preterm Birth Network. Red dots indicate approximate location of the 31 participating hospitals. Note: CAPSNet = Canadian Pediatric Surgery Network, CNFUN = Canadian Neonatal Follow-Up Network, CNN = Canadian Neonatal Network, CNTN = Canadian Neonatal Transport Network, CSMFM = Canadian Society of Maternal Fetal Medicine.