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Effect of Inborn versus Outborn Delivery on Clinical Outcomes in Ventilated Preterm Neonates: Secondary Results from the NEOPAIN Trial

Journal of Perinatology volume 25, pages 270–275 (2005)Cite this article

Abstract

OBJECTIVE:

The objective of this study was to evaluate the effect of birth center (inborn versus outborn) on morbidity and mortality for preterm neonates (23 to 32 weeks) using data collected prospectively within a uniform protocol.

STUDY DESIGN:

Secondary analyses of data from the NEurologic Outcomes & Pre-emptive Analgesia In Neonates (NEOPAIN) trial (n=898) were performed to evaluate the effect of inborn versus outborn delivery on neonatal outcomes, including the occurrence of severe intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), chronic lung disease (CLD), and mortality.

RESULTS:

Outborn babies were more likely to have severe IVH (p=0.0005); this increased risk persisted after controlling for severity of illness. When adjustments for antenatal steroids were added, the effect of birth center was no longer significant. Neither the occurrences of PVL or CLD nor mortality were significantly different between the inborn and outborn infants.

CONCLUSION:

Outborn babies are more likely to have severe IVH than inborn babies, perhaps because their mothers are less likely to receive antenatal steroids. Improvements in antenatal steroid administration to high-risk women may substantially reduce neonatal morbidity.

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Acknowledgements

This study was supported by the National Institute for Child Health and Human Development (HD36484 to K.J.S. Anand, HD36270 to B.A. Barton), from the Chief Scientist's Office of the Scottish Executive (to N. McIntosh), from the Swedish Research Council, Vardal Foundation and Free Masons, Sweden (to H. Lagercrantz and L.L. Bergqvist), from the Fondation pour la Santé CNP, France (to R. Carbajal and R. Lenclen), and from the Örebro University Hospital Research Foundation, Sweden (to J. Schollin and M. Eriksson). We gratefully acknowledge the contributions of all the physicians, nurses, pharmacists, ultrasonographers, occupational and physical therapists at the participating institutions, and the parents who gave consent for this study.

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Authors and Affiliations

  1. Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Kristine G Palmer MD, Charlotte A Hobbs MD, PhD, Richard W Hall MD & K J S Anand MBBS, DPhil

  2. Maryland Medical Research Institute, Baltimore, MD, USA

    Shari S Kronsberg MS & Bruce A Barton PhD

Authors
  1. Kristine G Palmer MD
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  2. Shari S Kronsberg MS
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  3. Bruce A Barton PhD
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  4. Charlotte A Hobbs MD, PhD
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  5. Richard W Hall MD
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  6. K J S Anand MBBS, DPhil
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Additional information

NEOPAIN=NEurologic Outcomes & Pre-emptive Analgesia In Neonates.

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Palmer, K., Kronsberg, S., Barton, B. et al. Effect of Inborn versus Outborn Delivery on Clinical Outcomes in Ventilated Preterm Neonates: Secondary Results from the NEOPAIN Trial. J Perinatol 25, 270–275 (2005). https://doi.org/10.1038/sj.jp.7211239

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