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It is not the ride: inter-hospital transport is not an independent risk factor for intraventricular hemorrhage among very low birth weight infants

Journal of Perinatology volume 33, pages 366–370 (2013)Cite this article

Subjects

Abstract

Objective:

The purpose of this study was to evaluate the relationship between intraventricular hemorrhage (IVH), inter-hospital transport and known potential risk factors for IVH.

Study Design:

Very low birth weight (VLBW <1500 g) infants admitted to a large regional neonatal intensive care unit within 48 h of life from 2005 to 2010 were identified. Logistic regression and proportional odds logistic regression models were used to compare inborn versus outborn patients with respect to IVH (any vs none) and IVH grade, respectively. Logistic regression was used to quantify the association between outborn status and mortality.

Result:

A total of 758 infants were included in the study (inborn=568, outborn=190). Outborn infants were found to have greater IVH severity than inborn (odds ratio (OR): 1.52; P=0.012). After accounting for 20 clinical and demographic variables in a multivariable model, the association between outborn status and IVH lacked statistical significance (OR: 1.14; P=0.56). Significant predictors of IVH grade included vaginal delivery (OR: 2.16; P<0.001), patent ductus arteriosus (OR: 1.65; P=0.005), 5-min Apgar (OR: 0.85; P=0.005) and gestational age (OR: 0.98; P=0.012). Sixty-nine (9.1%) of the infants died. After adjusting for potential confounders, the relationship between mortality and outborn status was not significant (OR:1.26; P=0.516). Significant predictors of mortality included gestational age (OR: 1.03; P=0.04) and 5-min Apgar (OR:1.22; P=0.02).

Conclusion:

Although VLBW infants transported during the first 2 days of life have higher rates of IVH than infants born at a tertiary care facility, this relationship may be explained by associations with underlying clinical variables rather than transport itself.

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Acknowledgements

This study received no external support. We gratefully acknowledge all of the caregivers, physicians, nurses, pharmacists, ultrasonographers, nutritionists, therapists, case managers and other staff who helped care for these patients, as well as the support staff involved in the collection of this data.

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Authors and Affiliations

  1. Department of Pediatrics, Monroe Carell Jr Children’s Hospital at Vanderbilt, Vanderbilt University School of Medicine, Nashville, TN, USA

    A Watson & W Walsh

  2. Department of Biostatistics, Monroe Carell Jr Children’s Hospital at Vanderbilt, Vanderbilt University School of Medicine, Nashville, TN, USA

    B Saville & Z Lu

  3. Division of Neonatology, Monroe Carell Jr Children’s Hospital at Vanderbilt, Vanderbilt University School of Medicine, Nashville, TN, USA

    W Walsh

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  1. A Watson
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  2. B Saville
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Correspondence to A Watson.

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Supplementary Information accompanies the paper on the Journal of Perinatology website

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Watson, A., Saville, B., Lu, Z. et al. It is not the ride: inter-hospital transport is not an independent risk factor for intraventricular hemorrhage among very low birth weight infants. J Perinatol 33, 366–370 (2013). https://doi.org/10.1038/jp.2012.126

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