Category: Obstetric Quality and Safety
Poster Session II
To examine the differences in preterm birth outcomes in neonates born in 2014 versus 2019 in the United States.
Study Design:
Retrospective analysis of the most recent National Inpatient Sample Database comparing neonatal outcomes of preterm births less than 37 weeks gestation in the years 2014 and 2019, before and after institution of multiple recent improvement guidelines such antenatal corticosteroids for late preterm delivery, delayed cord clamping, management of perinatal group B streptococcus, exclusive use of human milk, resuscitation of periviable infants, and use of non-invasive ventilation as primary mode of respiratory support in neonates.
Results:
Although there was no significant difference in preterm births rates between the years 2014 and 2019 (Table 1), there was a significant decrease in neonatal deaths during hospitalization after preterm birth (Table 2). There were a higher number of neonates who were managed by exclusive non-invasive ventilation in 2019 compared to 2014, and invasive ventilation rates were lower, however, the need for both remained steady ( Table 1). Diagnosis of respiratory distress syndrome in neonates was slightly higher in year 2019 compared to 2014, however, other neonatal complications like necrotizing enterocolitis, neonatal sepsis and intraventricular hemorrhage were lower (Table 2).
Conclusion:
Our study demonstrates that there has been a significant improvement in the preterm neonatal mortality and short-term outcomes in the United States between 2014 and 2019 despite steady preterm birth rates. This is likely due to multiple factors involving prenatal and postnatal management including newer national practice guidelines endorsed by SMFM, ACOG and AAP.
Ernesto Licon, MD
Maternal-Fetal Medicine Fellow
University of California at Irvine
Pasadena, California, United States
Fayez Bany-Mohammed, MD
Clinical Professor, Division of Neonatology, Pediatrics School of Medicine
University of California at Irvine
Irvine, California, United States
Afshan B. Hameed, MD
Professor Maternal Fetal Medicine & Cardiology
University of California, Irvine
Orange, California, United States