(Press-News.org) The advantage is particularly evident for very premature babies born after less than 27 weeks of pregnancy, where the figure rises to 50%, prompting the authors to conclude that new services for newborns should promote delivery of very preterm babies in high volume units.
How best to organise critical care for newborns has been the focus of intense debate, with the results of various studies indicating that centralised care is linked to better outcomes.
But after a review in 2003, the government in England decided to reconfigure services into managed clinical networks (MCNs). These offer some of the benefits of centralisation, while still permitting smaller units to remain open, in a bid to maintain ease and equity of access to services.
To gauge the impact of treatment volume within an MCN, the researchers looked at the survival and health of 20,554 premature babies admitted to 165 NHS hospital neonatal units in England between 2009 and 2011.
These units regularly contribute outcomes data to the National Neonatal Research Database, and were all part of the Neonatal Economic, Staffing, and Clinical Outcomes Project (NESCOP).
Some 17,955 of the babies were born between 27 and 32 weeks of pregnancy; 2559 were born after less than 27 weeks.
In all, 44 of the 165 hospitals (27%) had a level 3 or tertiary level neonatal unit - a designated specialist centre which receives referrals from other hospitals; 81 (49%) had a level 2 unit, which offer high dependency and some short term intensive care; and 39 (24%) had level 1 units, which don't provide high dependency or intensive care.
Almost one in 10 (1892) of the 20,554 babies were born in hospitals with neonatal units that were classified as high volume, but not tertiary level. And a slightly smaller proportion (1817) were born in neonatal units classified as tertiary level, but not high volume.
High volume was categorised as 3480 days of care each year given to babies born after less than 32 weeks of pregnancy.
There was no difference in survival rates between very premature babies admitted to either level 3 or other level neonatal units at the hospital of their birth. But there was a difference when it came to volume.
Overall, 394 (4.1%) newborns born prematurely after less than 33 weeks of pregnancy died in high volume units compared with 395 (3.6%) premature newborns in other units.
Babies born after less than 33 weeks of pregnancy and admitted to a high volume neonatal unit at the hospital of their birth were around 30% less likely to die within 28 days than those not admitted to this type of unit.
And very premature babies born after less than 27 weeks of pregnancy were almost 50% less likely to die if admitted to a high volume neonatal unit.
"The effect of volume on neonatal outcomes is an important consideration for policy makers deciding the optimal organisation of neonatal specialist services," conclude the authors.
Future research should also assess the impact of transfers, particularly in light of the reorganisation of MCNs into Operational Delivery Networks following the 2012 Health and Social Care Act, they add.
INFORMATION:
Premature newborn survival 30 percent higher in high volume neonatal centres
And 50 percent higher for very premature babies born after less than 27 weeks of pregnancy
2014-07-08
ELSE PRESS RELEASES FROM THIS DATE:
Study suggests consuming whey protein before meals could help improve blood glucose control in people with diabetes
2014-07-08
New research published in Diabetologia (the journal of the European Association for the Study of Diabetes) suggests that consuming whey protein before a regular breakfast reduces the blood sugar spikes seen after meals and also improves the body's insulin response. Thus whey protein could be an additional tool to help control blood sugar in patients with diabetes. The research was conducted in Israel by Professor Daniela Jakubowicz and Dr Julio Wainstein (Wolfson Medical Center, Tel Aviv University), Professor Oren Froy (Hebrew University of Jerusalem), Professor Bo Ahrén ...
Larger newborn care units provide better protection for very preterm babies
2014-07-08
Preterm babies admitted to high volume neonatal units are less likely to die compared to those admitted to low volume units, according to researchers.
A study, published in BMJ Open, has provided new estimates to assess how organisational factors in England impact clinical outcomes of infants born preterm.
Results demonstrated that for preterm babies born at less than 33 weeks gestation, the odds of dying in hospital were 32 per cent less if they were admitted to high volume units at the hospital of birth than if they were admitted to low volume units (odds ratio 0.68). ...
Annals of Internal Medicine tip sheet for July 8, 2014
2014-07-08
1. Task Force recommends against screening for carotid artery stenosis in general adult population
The United States Preventive Services Task Force recommends against screening for asymptomatic carotid artery stenosis in the general adult population, according to a recommendation statement being published in Annals of Internal Medicine. Stroke is a leading cause of death and disability in the United States and having carotid artery stenosis (a buildup of plaque in the carotid arteries that causes them to narrow) is a risk factor. although it accounts for a smaller number ...
Home visits by nurse may help reduce mortality in moms, children
2014-07-07
Women who had prenatal and infant/toddler nurse visits at home were less likely to die than women who did not and children whose mothers were visited by nurses were less likely to have died by age 20 from preventable causes.
Since 1990, the authors have been conducting a randomized clinical trial of a program of prenatal and infant/toddler home visits by nurses for very low-income, largely black mothers, having their first child.
The study assigned 1,138 mothers to 1 of 4 treatment groups: treatment 1 (transportation for prenatal care, n=166), treatment 2 (transportation ...
SAR11, oceans' most abundant organism, has ability to create methane
2014-07-07
CORVALLIS, Ore. – The oxygen-rich surface waters of the world's major oceans are supersaturated with methane – a powerful greenhouse gas that is roughly 20 times more potent than carbon dioxide – yet little is known about the source of this methane.
Now a new study by researchers at Oregon State University demonstrates the ability of some strains of the oceans' most abundant organism – SAR11 – to generate methane as a byproduct of breaking down a compound for its phosphorus.
Results of the study are being published this week in Nature Communications. It was funded ...
EARTH Magazine: Preserving Peru's petrified forest
2014-07-07
Alexandria, Va. — Tucked high in the Andes Mountains of northern Peru is a remarkable fossil locality: a 39-million-year-old petrified forest preserved in nearly pristine condition: stumps, full trees, leaves and all. With its existence unknown to scientists until the early 1990s — and its significance unbeknownst to villagers — this ancient forest hosts the remains of more than 40 types of trees, some still rooted, that flourished in a lowland tropical forest until they were suddenly buried by a volcanic eruption during the Eocene.
Since its discovery a little more than ...
New study of largely unstudied mesophotic coral reef geology
2014-07-07
MIAMI – A new study on biological erosion of mesophotic tropical coral reefs, which are low energy reef environments between 30-150 meters deep, provides new insights into processes that affect the overall structure of these important ecosystems. The purpose of the study was to better understand how bioerosion rates and distribution of bioeroding organisms, such as fish, mollusks and sponges, differ between mesophotic reefs and their shallow-water counterparts and the implications of those variations on the sustainability of the reef structure.
Due to major advancements ...
Discovery of Neandertal trait in ancient skull raises new questions about human evolution
2014-07-07
Re-examination of a circa 100,000-year-old archaic early human skull found 35 years ago in Northern China has revealed the surprising presence of an inner-ear formation long thought to occur only in Neandertals.
"The discovery places into question a whole suite of scenarios of later Pleistocene human population dispersals and interconnections based on tracing isolated anatomical or genetic features in fragmentary fossils," said study co-author Erik Trinkaus, PhD, a physical anthropology professor at Washington University in St. Louis.
"It suggests, instead, that ...
Bruce Museum scientist identifies world's largest-ever flying bird
2014-07-07
GREENWICH, CT, EMBARGOED UNTIL JULY 7, 2014 (3:00 PM EST) -- Scientists have identified the fossilized remains of an extinct giant bird that is likely to have the largest wingspan of any bird ever to have lived. A paper announcing the findings, "Flight Performance of the Largest Volant Bird," was published July 7 in the journal Proceedings of the National Academy of Sciences, and is authored by Dr. Daniel Ksepka, the newest Curator of Science at the Bruce Museum in Greenwich.
With a wingspan of 20 to 24 feet, Pelagornis sandersi was more than twice as big as the Royal ...
Scientist identifies world's biggest-ever flying bird
2014-07-07
DURHAM, N.C. -- Scientists have identified the fossilized remains of an extinct giant bird that could be the biggest flying bird ever found. With an estimated 20-24-foot wingspan, the creature surpassed size estimates based on wing bones from the previous record holder -- a long-extinct bird named Argentavis magnificens -- and was twice as big as the Royal Albatross, the largest flying bird today. Scheduled to appear online the week of July 7, 2014, in the journal Proceedings of the National Academy of Sciences, the findings show that the creature was an extremely efficient ...
LAST 30 PRESS RELEASES:
Scientists can tell healthy and cancerous cells apart by how they move
Male athletes need higher BMI to define overweight or obesity
How thoughts influence what the eyes see
Unlocking the genetic basis of adaptive evolution: study reveals complex chromosomal rearrangements in a stick insect
Research Spotlight: Using artificial intelligence to reveal the neural dynamics of human conversation
Could opioid laws help curb domestic violence? New USF research says yes
NPS Applied Math Professor Wei Kang named 2025 SIAM Fellow
Scientists identify agent of transformation in protein blobs that morph from liquid to solid
Throwing a ‘spanner in the works’ of our cells’ machinery could help fight cancer, fatty liver disease… and hair loss
Research identifies key enzyme target to fight deadly brain cancers
New study unveils volcanic history and clues to ancient life on Mars
Monell Center study identifies GLP-1 therapies as a possible treatment for rare genetic disorder Bardet-Biedl syndrome
Scientists probe the mystery of Titan’s missing deltas
Q&A: What makes an ‘accidental dictator’ in the workplace?
Lehigh University water scientist Arup K. SenGupta honored with ASCE Freese Award and Lecture
Study highlights gaps in firearm suicide prevention among women
People with medical debt five times more likely to not receive mental health care treatment
Hydronidone for the treatment of liver fibrosis associated with chronic hepatitis B
Rise in claim denial rates for cancer-related advanced genetic testing
Legalizing youth-friendly cannabis edibles and extracts and adolescent cannabis use
Medical debt and forgone mental health care due to cost among adults
Colder temperatures increase gastroenteritis risk in Rohingya refugee camps
Acyclovir-induced nephrotoxicity: Protective potential of N-acetylcysteine
Inhibition of cyclooxygenase-2 upregulates the nuclear factor erythroid 2-related factor 2 signaling pathway to mitigate hepatocyte ferroptosis in chronic liver injury
AERA announces winners of the 2025 Palmer O. Johnson Memorial Award
Mapping minds: The neural fingerprint of team flow dynamics
Patients support AI as radiologist backup in screening mammography
AACR: MD Anderson’s John Weinstein elected Fellow of the AACR Academy
Existing drug has potential for immune paralysis
Soft brainstem implant delivers high-resolution hearing
[Press-News.org] Premature newborn survival 30 percent higher in high volume neonatal centresAnd 50 percent higher for very premature babies born after less than 27 weeks of pregnancy