A retrospective comparison of VLBW outcomes before and after implementing new delivery room guidelines at a regional tertiary care center

J Perinatol. 2016 Mar;36(3):182-5. doi: 10.1038/jp.2015.187. Epub 2015 Dec 3.

Abstract

Objective: To evaluate the impact of implemented protocol changes on delivery room interventions and very low birth weight (VLBW) health outcomes.

Study design: Retrospective study comparing birth characteristics, interventions and health outcomes of VLBW infants born in a tertiary care center before (calendar years 2008 to 2009) and after (calendar years 2012 to 2013) implementing new protocols using Chi-square analyses.

Result: Four hundred and nine were born before and 303 after changes were implemented. Postimplementation infants had more use of antenatal steroids (P=0.02), gestational age ⩽24 weeks (P=0.03) and birth weights between 501 and 750 g (P=0.04) and less oxygen administration (P=0.002), face mask ventilation (P=0.0001), surfactant use (P=0.0001), chest compressions (P=0.0001), intubation (P=0.002), epinephrine use (P=0.011), hypothermia (P=0.0001) and discharges home on supplemental oxygen (P=0.05).

Conclusion: Changes creating a new delivery team, adopting new delivery practice guidelines and updating delivery room equipment resulted in positive outcomes for delivery room practices and patient outcomes.

Publication types

  • Comparative Study

MeSH terms

  • Birth Weight
  • Chi-Square Distribution
  • Delivery Rooms / standards*
  • Delivery Rooms / statistics & numerical data
  • Female
  • Gestational Age
  • Hospitals, Pediatric / organization & administration
  • Humans
  • Infant
  • Infant, Extremely Premature*
  • Infant, Newborn
  • Infant, Very Low Birth Weight*
  • Male
  • Oklahoma
  • Oxygen / therapeutic use
  • Practice Guidelines as Topic
  • Pregnancy
  • Pregnancy Outcome*
  • Pulmonary Surfactants / therapeutic use
  • Retrospective Studies
  • Tertiary Care Centers / organization & administration*

Substances

  • Pulmonary Surfactants
  • Oxygen