Background
Methods
Study population
Outcomes
Intensity of active perinatal care
Potential explanatory variables
Statistical methods
Sensitivity analyses
Results
Perinatal intensity level | |||||||||
---|---|---|---|---|---|---|---|---|---|
Low | Medium | High | |||||||
n | % | (95%CI) | n | % | (95%CI) | n | % | (95%CI) | |
Fetal admissions | 214 | (— reference —) | 249 | (— reference —) | 284 | (— reference —) | |||
Live born | 209 | 97.7 | (94.3 – 99.1) | 239 | 96.0 | (92.5 – 97.9) | 271 | 95.4 | (92.1 – 97.4) |
Admitted to NICU | 208 | 97.2 | (93.7 – 98.9) | 236 | 94.8 | (91 – 97.1) | 268 | 94.4 | (90.8 – 96.6) |
Survived to 2 years | 179 | 83.6 | (77.8 – 88.2) | 210 | 84.3 | (79.1 – 88.5) | 244 | 85.9 | (81.2 – 89.6) |
CP (n responding) | 153 | (— reference —) | 175 | (— reference —) | 211 | (— reference —) | |||
CP/sensory deficiency | 5 | 3.3 | (1.2 – 7.9) | 14 | 8.0 | (4.6 – 13.3) | 13 | 6.2 | (3.5 – 10.5) |
ASQ (n responding) | 113 | (— reference —) | 127 | (— reference —) | 162 | (— reference —) | |||
ASQ < threshold | 44 | 38.9 | (30 – 48.6) | 62 | 48.8 | (39.9 – 57.8) | 69 | 42.6 | (34.9 – 50.6) |
Imputed population∗ | 179 | – | – | 210 | – | – | 244 | – | – |
CP/sensorydeficiency∗ | – | 4.4 | (3.0 – 5.8) | – | 8.6 | (6.8 – 10.4) | – | 6.5 | (5.1 – 8.0) |
ASQ<threshold∗ | – | 47.5 | (44.0 – 50.9) | – | 54.1 | (50.9 – 57.3) | – | 47.1 | (44.1 – 50.1) |
Morbidity-free survival
Model | Medium intensity | High intensity | ||
---|---|---|---|---|
OR | (95% CI) | OR | (95% CI) | |
Survival (among fetuses alive at maternal admission to hospital) | ||||
Baseline | 1.05 | (0.64 – 1.75) | 1.20 | (0.72 – 1.97) |
Baseline + GA | 1.01 | (0.61 – 1.67) | 1.19 | (0.72 – 1.95) |
Baseline + GA + multiple status | 0.99 | (0.60 – 1.64) | 1.15 | (0.70 – 1.89) |
Baseline + extra variables | 0.96 | (0.54 – 1.71) | 1.12 | (0.63 – 2.00) |
Survival without sensorimotor morbidity (among fetuses alive at maternal admission to hospital) | ||||
Baseline | 1.04 | (0.60 – 1.81) | 1.39 | (0.80 – 2.44) |
Baseline + GA | 1.25 | (0.70 – 2.25) | 1.32 | (0.73 – 2.38) |
Baseline + GA + multiple status | 1.20 | (0.67 – 2.14) | 1.27 | (0.70 – 2.28) |
Baseline + extra variables | 1.09 | (0.59 – 2.01) | 1.16 | (0.62 – 2.16) |
CP and sensory disability (among survivors) | ||||
Baseline | 2.04 | (0.73 – 5.75) | 1.53 | (0.54 – 4.37) |
Baseline + GA | 2.11 | (0.73 – 6.11) | 1.54 | (0.52 – 4.50) |
Baseline + GA + multiple status | 2.10 | (0.72 – 6.15) | 1.53 | (0.52 – 4.53) |
Baseline + extra variables | 2.02 | (0.66 – 6.13) | 1.68 | (0.53 – 5.28) |
ASQ below threshold (among survivors) | ||||
Baseline | 1.27 | (0.72 – 2.24) | 0.98 | (0.57 – 1.68) |
Baseline + GA | 1.30 | (0.74 – 2.24) | 0.99 | (0.58 – 1.69) |
Baseline + GA + multiple status | 1.28 | (0.72 – 2.28) | 0.97 | (0.56 – 1.67) |
Baseline + extra variables | 1.35 | (0.76 – 2.40) | 1.01 | (0.58 – 1.76) |
Secondary outcomes
Sensitivity analyses
Model | Medium intensity | High intensity | ||
---|---|---|---|---|
OR | (95% CI) | OR | (95% CI) | |
CP and sensory disability (among survivors) | ||||
Indicator created from rates of: | ||||
Antenatal steroid exposure | 1.10 | (0.35 – 3.42) | 1.16 | (0.44 – 3.01) |
Delivery by Caesarean section | 0.98 | (0.40 – 2.40) | 0.49 | (0.14 – 1.71) |
Neonatal resuscitation in the DR | 1.76 | (0.59 – 5.25) | 1.46 | (0.50 – 4.33) |
ASQ below threshold (among survivors) | ||||
Indicator created from rates of: | ||||
Antenatal steroid exposure | 0.89 | (0.50 – 1.60) | 0.92 | (0.55 – 1.57) |
Delivery by Caesarean section | 0.83 | (0.50 – 1.37) | 0.88 | (0.50 – 1.55) |
Neonatal resuscitation in the DR | 1.59 | (0.88 – 2.89) | 1.19 | (0.68 – 2.06) |