Abstract
Increased survival of high-risk infants (HRI) born in tertiary care centers has led to the concept that in utero transportation of the HRI is superior to postpartum infant transportation. We evaluated this concept by comparison of 40 infants transported in utero (IUT) with 40 Infants transported in the first postpartum day (PPT). Infants were selected by comparing all IUT with the next consecutive admission transported from the same town or an equal distance (±50mi). Infants were then matched for gestational age (±2wk), birth weight (±100gm), and primary neonatal disease. Transport mortalities and other features of the two groups were then carefully analyzed for significance.
The IUT were no different from the PPT in number of mothers with >1 risk factor, toxemia, diabetes, or multiple births. More of the PPT were preterm (p<.05) and more IUT suffered premature rupture of membranes (p<.005). No differences were found in Apgars pH, TSP, serum glucose, or primary neonatal disease. Neither group suffered significant hypothermia. 37 infants required ventilation but no differences existed in peak ambient oxygen or end expiratory pressure requirements. Mean age of PPT at admission was 7.7 hours, and mean transport distance was 100 mi. Transport mortality was 12%, 10%, for IUT, PPT, respectively. Survival time for infants expiring in the first month and hospitalization time for neonatal survivors were similar. This study suggests that early PPT may be as valuable as IUT for the high-risk newborn.
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Rapoport, P., Bolam, D., Miyazaki, Y. et al. IN UTERO VERSUS POSTPARTUM TRANSPORTATION OF HIGH-RISK INFANTS. Pediatr Res 11, 541 (1977). https://doi.org/10.1203/00006450-197704000-01027
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DOI: https://doi.org/10.1203/00006450-197704000-01027