Neonatology
Poster Session 2
Drew M. Hensel, MD
Fellow
Washington University School of Medicine in St. Louis
St. Louis, MO, United States
Janet Chandarlis, RN
Washington University in St. Louis
St. Louis, MO, United States
Josh Hernandez, MPH
Washington University in St. Louis
St. Louis, MO, United States
Megan L. Lawlor, MD
Washington University School of Medicine in St. Louis
St. Louis, MO, United States
Nandini Raghuraman, MD MSCI (she/her/hers)
Assistant Professor
Washington University School of Medicine in St. Louis
St. Louis, Missouri, United States
Ebony B. Carter, MD, MPH (she/her/hers)
Associate Professor; Director, Division of Maternal Fetal Medicine
University of North Carolina at Chapel Hill
Chapel Hill, NC, United States
Anthony O. Odibo, MD (he/him/his)
Professor
Washington University School of Medicine in St. Louis
St. Louis, MO, United States
Barbara Warner, MD
Director, Division of Newborn Medicine
Washington University in St. Louis
St. Louis, MO, United States
Jeannie C. Kelly, MD, FACOG, MS
Associate Professor
Washington University School of Medicine in St. Louis, Barnes Jewish Hospital
St. Louis, MO, United States
Compared to neonatal transfers, maternal transfers to a Level IV Perinatal Care Center (PCC) have been associated with lower neonatal morbidity. Little is known regarding transfer outcomes for neonates born in the late preterm and term periods. We sought to compare neonatal outcomes between maternal and neonatal transfers to a Level IV PCC that delivered at ≥ 34 weeks.
Study Design:
This is a retrospective cohort study of maternal and neonatal transfers to a Level IV PCC from January – December 2021 who delivered at ≥ 34 weeks’ gestation. Maternal transfers delivered during the admission and neonatal transfers within 24 hours of delivery were included. Neonates were excluded if resuscitation was declined. The primary outcome was composite neonatal morbidity which included: respiratory distress syndrome (RDS), mechanical ventilation, sepsis, grade 3-4 intraventricular hemorrhage (IVH), chronic lung disease, necrotizing enterocolitis, patent ductus arteriosus, and stage 3-4 retinopathy of prematurity. Secondary outcomes included mode of delivery, APGARs < 7 at 5 minutes, length of neonatal stay, and each component of the composite score. Chi square, fisher exact, Mann Whitney U tests, and multivariate logistic regression were used as appropriate.
Results:
182 neonatal and 97 maternal transfers were included. Maternal transfers delivered at earlier gestational ages, were less likely to have congenital anomalies, and were more likely to receive antenatal steroids or be diagnosed with hypertensive disorders of pregnancy. Maternal transfers were significantly associated with lower odds of composite neonatal morbidity (aOR 0.71 [0.61-0.82]), specifically RDS (aOR 0.69 [0.60-0.79]) and mechanical ventilation (aOR 0.84 [0.75-0.95]). Length of neonatal stay did not differ.
Conclusion:
Compared to neonatal transports, maternal transports to a Level IV PCC have significantly lower odds of neonatal morbidity for deliveries ≥ 34 weeks. Our results underscore the importance of and continued need for robust maternal transport programs, even in the late preterm and term periods.