To determine whether birth and care in the highest-level hospitals (level III) compared with birth in or postnatal transfer to lower-level hospitals (level II) are associated with 5-year morbidity in very preterm children.
A cohort study.
All surviving 5-year-old children born very preterm (gestational age
In a population-based study cerebral palsy was diagnosed in 110 cases (2.4 per 1,000) among live born children with birth weight > or = 500 g (N = 45,976) during the 20-year period 1970-89 (cerebral palsy cases with a postneonatal etiology excluded). The incidence of cerebral palsy showed a linear declining trend from 2.8 per 1,000 in the first five-year cohort born 1970-74 to 2.0 per 1,000 in children born 1985-89 (p = 0.17). 15.9% of the decline in incidence of cerebral palsy from the first to the second ten-year cohort could be explained by a decreasing rate of low birth weight (500-2,499 g) in the population, from 4.2% 1970-79 to 3.8% 1980-89 (p
The aim of this study was to test a new method for continuous monitoring of the Danish contact person concept and to evaluate the impact of the concept on the mothers' perception of nursing care and on their self-efficacy.
This is a descriptive study, carried out at a neonatal unit forming part of a department of paediatrics. Using an electronic questionnaire, the mothers were asked if they had been given a contact nurse and how they assessed the quality of the care and their own self-efficacy. The correlation between their experience of being given a contact person and having high scores of nursing care and of self-efficacy was analyzed by logistic regression.
A total of 300 (81%) of the mothers answered the questionnaire. Among the mothers who acknowledged having had a contact nurse compared with those who did not, odds ratios were > 1 in 10/11 questions concerning assessment of nursing care. Concerning the mothers' assessment of their self-efficacy, the odds ratios were > 1 in 7/11 questions. None of these were statistically significant.
The study showed a tendency towards a positive impact on nursing care when contact persons were allocated to the mothers who were admitted to a neonatal ward. The findings were statistically significant in 2/11 questions.
A close connection exists between acute perinatal problems and prepartum diseases of mother and foetus. Good antenatal care of the mother, and both well-established and modern methods of assessing foetal well-being are important in prenatal care of the foetus. Close collaboration between obstetricians and neonatologists is essential to diagnose the high risk foetus. Some medical and surgical foetal conditions can now be treated in utero. Usually, however, the obstetrician and the neonatologist have to decide on the correct timing for delivery of the high risk foetus and the route of delivery. Even during normal vaginal delivery there is progressive foetal acidosis and hypoxia. Despite this, with modern obstetric care, most newborn infants are well, with adequate respiration when 1-2 minutes old. Only about one neonate in 50 requires active resuscitation in the labour ward. This article summarizes the principles of this resuscitation, as well as the principles for treating some of the acute diseases in the perinatal period.
The aim of this study was to describe the experiences of being a father to a prematurely born infant. Eight fathers of prematurely born children were interviewed using a narrative approach, and a thematic content analysis was used to analyse the interviews. The fathers described that the preterm birth gave them the chance to get to know their infant as they had to spend time at the intensive care unit. They also felt better educated by professionals who helped them take care of their infant. Their feelings and attachment for their infant increased over time and the fathers felt that they had a stronger bond with their child compared with friends who had babies born at term. As time passed, they became more confident as a father. In spite of the strain, the experience made them change as a person and they expressed having different values. The relationship with their partner was strengthened as they handled this situation together as a couple. However, the fathers felt fortunate despite everything and described having managed a prematurely born infant rather well. Although there are similarities between being a father to a child born at term and to one born preterm, it is significant to gain further knowledge about the specific experiences of fathers of prematurely born infants. The results of this study have implications for nurses working with families who have children born prematurely.
Few Canadian studies have examined the association between adolescent pregnancy and adverse pregnancy outcomes. The objective of this cohort study was to characterize the association between adolescent pregnancy and specific adverse maternal, obstetrical, and neonatal outcomes, as well as maternal health behaviours.
We conducted a retrospective population-based cohort study of all singleton births in Ontario between January 2006 and December 2010, using the Better Outcomes Registry and Network database. Outcomes for pregnant women
Advances in biomedical engineering enable us to treat increasingly severe conditions. This implies an increased need for regulation and priority setting in healthcare, to ensure appropriate safety cautions and to avoid accelerating expenditures. This interview study investigates the mechanisms behind the adoption and use of medical devices through the subjective experiences of hospital staff working with devices for neonatal intensive care. The adoption was found to be primarily initiated by vendor activities, but professionals preferably sought information about functionality from close colleagues. Full integration of devices was sometimes not achieved, and even though the adopting units had good introduction routines, there was no systematic follow-up of how adopted devices had been integrated in the work practices. Diffusion variations were, however, mainly found for temporarily tested devices and not for permanently available technologies. Three factors were found to be the major explanatory variables of the adoption of medical devices: (1) the subjective expected value of the device, (2) information and learning, and (3) the innovativeness of the adopting unit.
Standardized risk assessment plays an important role in providing medical care of uniform quality to pregnant women, even though it is not a substitute for clinical judgement. This study was designed to determine whether the antepartum risk score currently used across Alberta is associated with neonatal morbidity and adverse pregnancy outcomes for singleton live births and to examine whether the current classification of "lower risk" pregnancies (score