Newborn and Infant Nursing Reviews
Volume 9, Issue 4 , Page 183, December 2009

Editorial

Mercy Anderson Hospital, Cincinnati, Ohio, USA

Article Outline

 

The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists have guidelines for perinatal care in which they recommend that hospital-based services be organized within geographic regions to provide optimal access to expertise and experience.1 According to these guidelines, very-low-birth-weight (VLBW; <1500 grams) should be delivered at subspecialty perinatal centers, defined by their ability to provide comprehensive care for pregnant women and neonates of all-risk categories.2 Studies have shown that VLBW infants born at nonsubspecialty centers have a 1.5 to 2.8 times increased risk of death when compared with VLBW infants born at specialty centers.3, 4, 5 Additional studies comparing outcomes of VLBW infants who were outborn to those inborn at subspecialty centers found similar results.6, 7 Although regionalization is the goal, VLBW, premature, or distressed term infants continue to need immediate transport to or from a neonatal intensive care unit for further definitive diagnosis and treatment.8 The transfer of high-risk infants requires a specialized neonatal transport team proficient in maintaining thermoregulation and monitoring heart rate, breathing, blood pressure, and blood oxygen concentrations, in addition to supporting ventilation, intravenous infusions, and advanced treatment modalities during transport.9

This issue of Newborn and Infant Nursing Reviews mainly focuses on the transport of high-risk neonates, and it is my pleasure to introduce Amy Knupp as the guest editor for the December issue. Amy Knupp, RN, MSN, CNS, is currently the BPD Nurse Coordinator at Nationwide Children's Hospital in Columbus, Ohio. She was formerly the neonatal intensive care unit Clinical Nurse Specialist at the Akron Children's Hospital, in Akron, Ohio, where she had firsthand experience with neonatal transports for over 8 years. She is highly qualified as a guest editor on this topic.

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References 

  1. American Academy of Pediatrics , American College of Obstetrics and Gynecology . Guidelines for perinatal care. 6th ed.. Washington, DC: American Academy of Pediatrics; 2007;
  2. March of Dimes Birth Defects Foundation (COPH) . Toward improving the outcome of pregnancy: the 90's and beyond. White Plains, NY. 1993;
  3. Kirby RS. Perinatal mortality: The role of hospital of birth. J Perinatol. 1996;16:43–49
  4. Cifuentes J, Bronstein J, Phibbs R, Schmitt SK, Carlo WA. Mortality in low-birth weight infants according to level of neonatal care at hospital of birth. Pediatrics. 2002;109:745–751
  5. Warner B, Imhoff S. In:  Altimier L editors. Regionalization. St. Louis (Mo): Mosby's Neonatal Nursing Online Course; 2007;
  6. Chien LY, Whyte R, Aziz K, Thiessen P, Matthew D, Lee SK. Improved outcomes of preterm infants when delivered in tertiary care centers. Obstetr Gynecol. 2001;98:247–252
  7. Haupsy J, Jacquemyn Y, Van Reempts P, Buytaert P, Van Vliet J. Intrauterine versus postnatal transport of the preterm infant: a short-distance experience. Early Hum Dev. 2001;63:1–7
  8. Fanaroff A, Graven S. Perinatal services and resources. In:  Fanaroff A,  Martin R editor. Neonatal-Perinatal medicine. 5th ed.. St. Louis: Mosby-Year book; 1992;p. 12–21
  9. Imhoff S. Neonatal transports. In:  Altimier L editors. St. Louis (Mo): Mosby's Neonatal Nursing Online Course; 2007;

PII: S1527-3369(09)00128-7

doi:10.1053/j.nainr.2009.09.001

Newborn and Infant Nursing Reviews
Volume 9, Issue 4 , Page 183, December 2009

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