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Comparison of neonatal morbidity and mortality between single-room and open-bay care: a retrospective cohort study
  1. Sophie Jansen1,
  2. Romy J M Berkhout1,
  3. Arjan B te Pas1,
  4. Sylke J Steggerda1,
  5. Linda S de Vries1,
  6. Nicoline Schalij-Delfos2,
  7. Alieke van der Hoeven3,
  8. Enrico Lopriore1,
  9. Vincent Bekker1
  1. 1 Division of Neonatology, Department of Pediatrics, Leiden University Medical Center (LUMC), Leiden, Netherlands
  2. 2 Department of Ophthalmology, Leiden University Medical Center (LUMC), Leiden, Netherlands
  3. 3 Department of Medical Microbiology, Leiden University Medical Center (LUMC), Leiden, Netherlands
  1. Correspondence to Ms Sophie Jansen, Division of Neonatology, Department of Pediatrics, Leiden University Medical Center (LUMC), Leiden, Netherlands; s.j.jansen{at}lumc.nl

Abstract

Objective In response to the increasing focus on family-centred care, neonatal intensive care unit (NICU) environments have gradually shifted towards the single-room design. However, the assumed benefits of this emerging design remain a subject of debate. Our goal was to evaluate the impact of single-room versus open-bay care on the risk of neonatal morbidity and mortality in preterm neonates.

Design Retrospective cohort study.

Setting Level III NICU.

Patients Neonates born <32 weeks’ gestation between 15 May 2015 and 15 May 2019.

Main outcome measures Mortality and morbidities of a cohort of neonates admitted to a new, single-room unit (SRU) were compared with a historical cohort of neonates admitted to an open-bay unit (OBU). Group differences were evaluated and multivariable logistic regression analyses were performed.

Results Three-hundred and fifty-six and 343 neonates were admitted to the SRU and OBU, respectively. No difference in neonatal morbidities and mortality were observed between cohorts (bronchopulmonary dysplasia: OR 1.08, 95% CI 0.73 to 1.58, p=0.44; retinopathy of the prematurity stage ≥2: OR 1.36, 95% CI 0.84 to 2.22, p=0.10; intraventricular haemorrhage: OR 0.89, 95% CI 0.59 to 1.34, p=0.86; mortality: OR 1.55, 95% CI 0.75 to 3.20, p=0.28). In adjusted regression models, single-room care was independently associated with a decreased risk of symptomatic patent ductus arteriosus (adjusted OR 0.54, 95% CI 0.31 to 0.95). No independent association between single-room care and any of the other investigated outcomes was observed.

Conclusions Implementation of single-rooms in our NICU did not lead to a significant reduction in neonatal morbidity and mortality outcomes.

  • Mortality
  • Neonatology
  • Intensive Care Units, Neonatal

Data availability statement

Data are available upon request from the corresponding author.

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Data availability statement

Data are available upon request from the corresponding author.

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  • Contributors SJ collected and analysed the data, drafted the initial and final version of the manuscript and is responsible for the overall content as the guarantor. ABtP, NE and AvdH critically reviewed and revised the manuscript for important intellectual content. RJMB, SJ and LSdV collected a part of the data and critically reviewed and revised the manuscript for important intellectual content. EL and VB conceptualised the study, supervised data collection and critically reviewed and revised the manuscript for important intellectual content. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.