Changes In Perinatal Hospital Deaths Occurring Outside The Neonatal Intensive Care Unit Over A Decade

Changes In Perinatal Hospital Deaths Occurring Outside The Neonatal Intensive Care Unit Over A Decade

Du Pont-Thibodeau Amélie; Barrington K; Taillefer Catherine; Janvier A

10.1111/apa.13884

Acta Paediatrica

2017

Ethics; Neonatology; Outcomes; Palliative Care; Perinatal Death

AIM: Perinatal deaths occurring outside the neonatal intensive care unit (NICU) are rarely recorded in outcome studies, despite having a direct impact on perinatal statistics. Our aim was to investigate the timing and modes of perinatal deaths that occurred outside the NICU and changes over time. METHOD: We reviewed all perinatal deaths from 22 weeks of gestation onwards, without NICU admissions, during two periods in a Canadian tertiary mother and baby hospital and categorised deaths according to nine specific categories. RESULTS: There were 444 perinatal deaths that satisfied the inclusion criteria. The total number of perinatal deaths increased from 2000 to 2002 (n=197) and 2007 to 2010 (n=247). The proportion of fetuses alive at the time of their mother's hospital admission, but then stillborn, decreased. There was a significant increase in terminations for congenital anomalies in the second cohort, and a decrease in deaths following induction of labour and comfort care for fetal anomalies. CONCLUSION: Approaches to end of life care changed between the two study periods. Paediatricians should be aware of the epidemiology of perinatal mortality in their own practice, as it has a direct impact on the denominator in NICU outcome studies. This article is protected by copyright. All rights reserved.

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June 2017 List

http://www.ncbi.nlm.nih.gov/pubmed/28434210