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Incubator weaning in preterm infants and associated practice variation

Journal of Perinatology volume 29, pages 570–574 (2009)Cite this article

Abstract

Objective:

To evaluate the relationship of weight of preterm infants when first placed into an open crib with days to full oral feedings, growth velocity and length of stay (LOS), and to identify unwarranted variation in incubator weaning after adjusting for severity indices.

Study Design:

A retrospective study using the ParadigmHealth neonatal database from 2003 to 2006 reviewed incubator weaning to an open crib in appropriate-for–gestational-age (AGA) infants from 22 to weeks gestation. Primary outcome measurements included days to full oral (PO) feeding, weight gain from open crib to discharge and length of stay. Models were severity adjusted. To understand hospital practice variation, we also used a regression model to estimate the weight at open crib for the top 10 volume hospitals.

Result:

In all 2908 infants met the inclusion criteria for the study. Their mean weight at open crib was 1850 g. On average every additional 100 g an infant weighed at the open crib was associated with increased time to full PO feeding by 0.8 days, decreased weight gained per day by 1 gram and increased LOS by 0.9 days. For the top 10 volume hospitals, severity variables alone accounted for 9% of the variation in weight at open crib, whereas the hospital in which the baby was treated accounted for an additional 19% of the variation.

Conclusion:

Even after controlling for severity, significant practice variation exists in weaning to an open crib, leading to potential delays in achieving full-volume oral feeds, decreased growth velocity and prolonged LOS.

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Acknowledgements

No specific financial support was provided to any of the authors for their participation in this paper.

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Authors and Affiliations

  1. Alere (formerly ParadigmHealth), Marietta, GA, USA

    R Schneiderman, S Kirkby & W Turenne

  2. Thomas Jefferson University and Nemours/A.I. duPont Hospital for Children, Philadelphia, PA, USA

    J Greenspan

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  1. R Schneiderman
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  2. S Kirkby
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  3. W Turenne
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  4. J Greenspan
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Correspondence to R Schneiderman.

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Schneiderman, R., Kirkby, S., Turenne, W. et al. Incubator weaning in preterm infants and associated practice variation. J Perinatol 29, 570–574 (2009). https://doi.org/10.1038/jp.2009.54

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