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Clinical Characteristics of Inborn and Outborn Infants Admitted to the NICU

Journal of the Korean Pediatric Society 1993;36(12):1647-1655.
Published online December 15, 1993.
Clinical Characteristics of Inborn and Outborn Infants Admitted to the NICU
Hyun Cheol Lee, Jin Young Choi, Hwang Min Kim, Baek Keun Lim, Jong Soo Kim
Department of Pediatrics, Yonsei University, Wonju College of Medicine, Wonju, Korea
신생아 중환자실에 입원한 원내 출생아와 원외 출생아의 임상적 비교 관찰
이현철, 최진영, 김황민, 임백근, 김종수
연세대학교 원주의과대학 소아과학교실
Abstract
Regionalization of high-risk perinatal care has been advocated because intensive care of small and ill newborn infants lowers mortality and morbidity. This report is based on analysis of admissions to the Neonatal Intensive Care Unit (NICU) at the Wonju Christian Hospital during the 4-year period from January, 1988 to December, 1991. There were 786 inborn infants and 1155 outborn infants admitted to the NICU. The results of our study follow ; 1) Mean gestational ages were 36.8 weeks in inborn infants and 39.0 weeks in outborn infants. Mean birth weight was 2.5kg in inborn and 3.0kg in outborn infants. 2) The high-risk maternal factors, such as cesarian delivery, eclampsia, preeclampsia, multiple pregnancy and placental anomaly were significantly more frequent in inborn infants than in outborn infants. 3) Perinatal sphyxia, HMD and transient tachypnea of newborn (TTN) were more common in inborn than in outborn infants, but pneumonia, meconium aspiration syndrome, and seizure were more common in outborn infants. 4) The positivity of bacterial cultures in blood and urine was higher in outborn infants than in inborn infants. The most frequently isolated microorganism was staphylococcus species in born inborn and outborn infants. 5) Hospital days, duration of TPN, duration of mechanical ventilation, frequency of seizure, and frequency of transfusion were longer or more frequent in inborn than in outborn infants. 6) Mortality rate was higher in inborn infants than in outborn infants. 7) In outborn infants, mortality rate was higher in infants whose transporting time was longer than 2 hours than for infants within 2 hour distances. However, this difference was not statistically significant. 8) These findings suggest that many lower birth weight and severly ill infants were not transported to the NICU of Wonju Christian Hospital perhaps due to poor transport systems, distance or socio-economic status. In conclusion, the improvement of transporting systems and socio-economic conditions will be required within this region.
Key Words: Regionalization, Neonatal Intensive care Unit (NICU), Inborn, Outborn


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