Mortality and morbidity to discharge for babies of women transferred antenatally and for those who delivered in level 2 and level 3 services without transfer for births in England in 2006 between 22 and 26 weeks of gestation
| Outcome | Level 2 (n=829) | Antenatal transfer (n=440) | Level 3 (n=947) | p Value* | aOR L3 vs L2 | aOR Level 2 v ANT | aOR Level 3 vs ANT | |||
|---|---|---|---|---|---|---|---|---|---|---|
| Antenatal death | 174 | 21% | 45 | 10% | 163 | 17% | 0.104 | 0.86 (0.66 to 1.13) | 1.52 (1.03 to 2.26) | 1.31 (0.89 to 1.93) |
| Delivery room deaths† | 143 | 17% | 30 | 7% | 118 | 12% | 0.002 | 0.53 (0.37 to 0.77) | 1.67 (1.02 to 2.72) | 0.89 (0.54 to 1.46) |
| Neonatal unit deaths <7 days | 116 | 14% | 50 | 11% | 118 | 12% | 0.005 | 0.69 (0.51 to 0.94) | 1.80 (1.23 to 2.63) | 1.25 (0.86 to 1.81) |
| All early neonatal deaths | 259 | 31% | 80 | 18% | 236 | 25% | 0.0001 | 0.61 (0.47 to 0.79) | 1.85 (1.33 to 2.57) | 1.12 (0.81 to 1.56) |
| Late neonatal death (7–28 days)† | 56 | 7% | 43 | 10% | 79 | 8% | 0.932 | 0.94 (0.64 to 1.38) | 1.08 (0.69 to 1.68) | 1.01 (0.67 to 1.53) |
| Death 29 days to discharge | 35 | 4% | 32 | 7% | 54 | 6% | 0.853 | 1.08 (0.68 to 1.73) | 0.86 (0.50 to 1.46) | 0.93 (0.57 to 1.51) |
| All deaths | 524 | 63% | 200 | 45% | 532 | 56% | 0.014 | 0.75 (0.59 to 0.95) | 1.44 (1.09 to 1.90) | 1.08 (0.83 to 1.41) |
| Survival without morbidity | 70 | 8% | 65 | 15% | 92 | 10% | 0.086 | 1.14 (0.80 to 1.61) | 0.65 (0.44 to 0.96) | 0.74 (0.51 to 1.06) |
| Survivors only | ||||||||||
| No morbidity | 70 | 23% | 65 | 27% | 92 | 22% | 0.166 | 0.99 (0.69 to 1.43) | 0.72 (0.48 to 1.08) | 0.71 (0.49 to 1.04) |
| Perinatal factors | ||||||||||
| Antenatal steroid (any) | 531/824 | 64% | 412/436 | 95% | 656/936 | 70% | <0.0001 | 1.15 (0.90 to 1.47) | 0.20 (0.12 to 0.31) | 0.23 (0.14 to 0.36) |
| Resuscitation withheld | 89/653 | 14% | 12/395 | 3% | 61/784 | 8% | 0.002 | 0.41 (0.25 to 0.66) | 1.25 (0.62 to 2.55) | 0.51 (0.24 to 1.09) |
| Alive with HR>100 at 5 m | 463/551 | 84% | 342/379 | 90% | 610/710 | 86% | 0.243 | 1.16 (0.84 to 1.60) | 0.70 (0.46 to 1.06) | 0.81 (0.53 to 1.22) |
| Admitted to NNU | 511/829 | 62% | 365/440 | 83% | 664/947 | 70% | 0.014 | 1.41 (1.09 to 1.81) | 0.69 (0.50 to 0.96) | 0.98 (0.70 to 1.35) |
*p Value for overall significance of transfer adjusted for gestational age and birthweight for gestation.
†Heterogeneity of effect of antenatal transfer across gestational age for two outcomes (p=0.048 for delivery room and p=0.039 for late neonatal deaths).
ANT, antenatal transfer; aOR, OR adjusted for gestational age and birthweight for gestation based on population alive at start of time period.