Background: To compare perinatal characteristics of very preterm births between two regions, the state of New South Wales/Australian Capital Territory (NSW/ACT) in Australia and the Trent Health Region (Trent) in the United Kingdom.
Methods: Study population: NSW/ACT: Ongoing prospective population based cohort study of all infants 22–31 weeks gestation born 1/1/2000 to 31/12/2002 admitted to a tertiary neonatal intensive care unit (NICU) in NSW (n=9) or the ACT (n=1). Infants born in non-tertiary hospitals near the northern, southern and western borders of NSW are transferred interstate for intensive care. Total births obtained from NSW Midwives Data Collection and ACT Maternal-Perinatal Data Collection. Population characteristics obtained from Australian Bureau of Statistics, 2001 Census. Trent: The Trent neonatal Survey is an on-going prospective study of neonatal care established in 1990. Data was available for all babies <33 weeks gestation for the study period who entered a neonatal unit. All stillbirths and live born babies not admitted to an intensive care unit (non viable) at this gestation were identified by the Trent Confidential Enquiry into Stillbirths and Deaths in Infancy (CESDI).
Results: Population characteristics for NSW/ACT and Trent respectively: 5146 (2938 v 2208) infants 22–31 weeks gestation, were live born of whom 4766 (2681; 91.3% v 2085; 94.4%) were admitted to a NICU in the study area between 1/1/2000 and 31/12/2002. Infant characteristics for NSW/ACT and Trent respectively: There was no difference in mean birth weight (1226.4+/−387.5 v 1224.1+/−388.5) and gestational age (28.5+/−2.2 v 28.6+/−2.3). NSW/ACT had significantly more multiple births than Trent (OR 1.45; 95%CI 1.27–1.65). Management practices and outcomes: NSW/ACT babies were more likely than Trent babies to be transported after birth (OR 3.44; 95%CI 3.05–3.88), to receive antenatal corticosteroids (OR 1.38; 95%CI 1.17–1.63) and to have continuous positive airway pressure [CPAP] (OR 2.50; 95%CI 2.21–2.82). They were less likely to receive surfactant (OR 0.49; 95%CI 0.44–0.55). There was no difference in caesarean section, mechanical ventilation, oxygen (infants alive at 28 days), and mortality (neonatal and total). NSW/ACT babies were sicker CRIB II - 8 (IQR 5,11) v 6 (IQR 4,9) and hospitalised for longer (survivors) 55 (IQR 42,78) days v 48 (IQR 33,71) days than Trent babies.
Conclusion: The differences in the two regions can be accounted for by management practices geographical variations.
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Bajuk, B., Field, D., Vincent, T. et al. 14 A Comparison of Perinatal Characteristics between Two Regions: Trent, United Kingdom and New South Wales and Australian Capital Territory, Australia, 2000–2002. Pediatr Res 56, 466 (2004). https://doi.org/10.1203/00006450-200409000-00037