Impact of Outborn/Inborn Birth Status of Infants Born at <29 Weeks of Gestation on Neurodevelopmental Impairment: A Nationwide Cohort Study in Korea

In Young Cho, Hye Mi Lee, Sae Yun Kim () and Eun Sun Kim ()
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In Young Cho: Department of Pediatrics, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea
Hye Mi Lee: Department of Pediatrics, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea
Sae Yun Kim: Department of Pediatrics, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea
Eun Sun Kim: Department of Pediatrics, Kangwon National University School of Medicine, Chuncheon 24341, Korea

IJERPH, 2022, vol. 19, issue 18, 1-11

Abstract: This study designed to evaluate the short- and long-term outcomes of outborn and inborn preterm infants enhancing the regional perinatal system in South Korea. It is a prospective cohort study of the Korean neonatal network database for infants born at <29 weeks of gestation between 2013 and 2015. Of 2995 eligible infants, 312 were outborn, and 976 completed the assessment of long-term outcome at 18–24 months of corrected age. The mean gestational age was significantly younger in outborn infants than in inborn infants ( p = 0.004). The mean Apgar score at 5 min was higher in inborn infants ( p = 0.046). More inborn preterm infants died before discharge ( p < 0.001); however, most of the other short-term outcomes occurred significantly more often in outborn infants than in inborn infants. The outborn infants had higher odds of neurodevelopmental impairment (adjusted odds ratio (aOR) 2.412, 95% confidence interval (CI) 1.585–3.670), cerebral palsy (aOR 4.460, 95% CI 2.249–8.845) and developmental impairment (aOR 2.238, 95% CI 1.469–3.408). In preterm infants, the location of birth may be a key factor influencing short- and long-term outcomes. Thus, to provide adequate care and efficiently allocate medical resources to high-risk preterm infants, nationwide regional perinatal systems need to be improved and standardized.

Keywords: inborn; outborn; perinatal retrieval system; preterm (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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