Development and testing of a resuscitation-specific measure of organizational culture for resuscitation teams.

Background: The organizational culture (shared beliefs, perceptions, and values) of teams informs their behaviours and practices. Little is known about organizational culture for resuscitation teams. Our objective was to develop a reliable and valid resuscitation-specific organizational culture instrument (ROCI) with the goal of improving team performance.

National Variation in Black Immigrant Preterm Births and the Role of County-Level Social Factors.

Preterm birth rates among Black individuals continue to be inequitably high in the USA. Black immigrants appear to have a preterm birth advantage over US-born counterparts. This national cross-sectional study of singleton non-Hispanic Black individuals in the USA from 2011 to 2018 aimed to investigate if the Black immigrant preterm birth advantage varied geographically and how this advantage associated with county-level social drivers of health.

County-Level Structural Vulnerabilities in Maternal Health and Geographic Variation in Infant Mortality.

Objective: To evaluate whether community factors that differentially affect the health of pregnant people contribute to geographic differences in infant mortality across the US.

Study Design: This retrospective cohort study sought to characterize the association of a novel composite measure of county-level maternal structural vulnerabilities, the Maternal Vulnerability Index (MVI), with risk of infant death. We evaluated 11 456 232 singleton infants born at 22 0 of 7 through 44 6 of 7 weeks' gestation from 2012 to 2014.

Preterm Birth Risk and Maternal Nativity, Ethnicity, and Race.

Importance: Immigrant birthing people have lower rates of preterm birth compared with their US-born counterparts. This advantage and associated racial and ethnic disparities across the gestational age spectrum have not been examined nationally.

Objective: To examine associations of maternal nativity, ethnicity, and race with preterm birth.

The impact of volume and neonatal level of care on outcomes of moderate and late preterm infants.

Objective: Evaluate the relationship of neonatal unit level of care (LOC) and volume with mortality or morbidity in moderate-late preterm (MLP) (32-36 weeks' gestation) infants.

Design: Retrospective cohort study of 650,865 inborn MLP infants in 4976 hospitals-years using 2003-2015 linked administrative data from 4 states. Exposure was combined neonatal LOC and MLP annual volume.

Transfer Patterns Among Infants Born at 28 to 34 Weeks' Gestation.

Background: Although postnatal transfer patterns among high-risk (eg, extremely preterm or surgical) infants have been described, transfer patterns among lower-risk populations are unknown. The objective was to examine transfer frequency, indication, timing, and trajectory among very and moderate preterm infants.

Methods: Observational study of the US Vermont Oxford Network all NICU admissions database from 2016 to 2021 of inborn infants 280/7 to 346/7 weeks.

Inter-hospital Variation in COVID-19 Era Pediatric Hospitalizations by Age Group and Diagnosis.

Background: Mitigation strategies and public responses to coronavirus disease 2019 (COVID-19) varied geographically and may have differentially affected burden of pediatric disease and hospitalization practices. We aimed to quantify hospital-specific variation in hospitalizations during the COVID-19 era.

Methods: Using Pediatric Health Information Systems data from 44 Children's Hospitals, this retrospective multicenter analysis compared hospitalizations of children (1 day-17 years) from the COVID-19 era (March 1, 2020-June 30, 2021) to prepandemic (January 1, 2017-December 31, 2019).

Perinatal Care Measures Are Incomplete If They Do Not Assess The Birth Parent-Infant Dyad As A Whole.

Measures of perinatal care quality and outcomes often focus on either the birth parent or the infant. We used linked vital statistics and hospital discharge data to describe a dyadic measure (including both the birth parent and the infant) for perinatal care during the birth hospitalization. In this five-state cohort of 2010-18 births, 21.

Obstetric Volume and Severe Maternal Morbidity Among Low-Risk and Higher-Risk Patients Giving Birth at Rural and Urban US Hospitals.

Importance: Identifying hospital factors associated with severe maternal morbidity (SMM) is essential to clinical and policy efforts.

Objective: To assess associations between obstetric volume and SMM in rural and urban hospitals and examine whether these associations differ for low-risk and higher-risk patients.

Design, Setting, And Participants: This retrospective cross-sectional study of linked vital statistics and patient discharge data was conducted from 2022 to 2023.

County-Level Maternal Vulnerability and Preterm Birth in the US.

Importance: Appreciation for the effects of neighborhood conditions and community factors on perinatal health is increasing. However, community-level indices specific to maternal health and associations with preterm birth (PTB) have not been assessed.

Objective: To examine the association of the Maternal Vulnerability Index (MVI), a novel county-level index designed to quantify maternal vulnerability to adverse health outcomes, with PTB.

Association Between Neonatal Intensive Care Unit Type and Quality of Care in Moderate and Late Preterm Infants.

Importance: A higher level of care improves outcomes in extremely and very preterm infants, yet the impact of neonatal intensive care unit (NICU) level on moderate and late preterm (MLP) care quality is unknown.

Objective: To examine the association between NICU type and care quality in MLP (30-36 weeks' gestation) and extremely and very preterm (25-29 weeks' gestation) infants.

Design, Setting, And Participants: This cohort study was a prospective analysis of 433 814 premature infants born in 465 US hospitals between January 1, 2016, and December 31, 2020, without anomalies and who survived more than 12 hours and were transferred no more than once.

Exposure to umbilical cord management approaches and death or neurodevelopmental impairment at 22-26 months' corrected age after extremely preterm birth.

Objective: To compare death or severe neurodevelopmental impairment (NDI) at 22-26 months' corrected age (CA) among extremely preterm infants following exposure to different forms of umbilical cord management.

Design: Retrospective study.

Setting: National Institute of Child Health and Human Development Neonatal Research Network registry.

Use of ventilation/perfusion mismatch to guide individualised CPAP level selection in preterm infants: a feasibility trial.

Objective: To measure within-subject changes in ventilation/perfusion (V'/Q') mismatch in response to a protocol of individualised nasal continuous positive airway pressure (CPAP) level selection.

Design: Single-arm, non-randomised, feasibility trial.

Setting: Three centres in the Children's Hospital of Philadelphia neonatal care network.

Perinatal outcomes for rural obstetric patients and neonates in rural-located and metropolitan-located hospitals.

Objective: To compare rural obstetric patient and neonate characteristics and outcomes by birth location.

Methods: Retrospective observational cohort study of rural residents' hospital births from California, Pennsylvania, and South Carolina. Hospitals in rural counties were rural-located, those in metropolitan counties with ≥10% of obstetric patients from rural communities were rural-serving, metropolitan-located, others were non-rural-serving, metropolitan-located.

Variation and Temporal Trends in Delivery Room Management of Moderate and Late Preterm Infants.

Background: Although delivery room (DR) intervention decreases with increasing gestational age (GA), little is known about DR management of moderate and late preterm (MLP) infants.

Methods: Using the Vermont Oxford Network database of all NICU admissions, we examined the receipt of DR interventions including supplemental oxygen, positive pressure ventilation, continuous positive airway pressure, endotracheal tube ventilation, chest compressions, epinephrine, and surfactant among MLP infants (30 to 36 weeks') without congenital anomalies born from 2011 to 2020. Pneumothorax was examined as a potential resuscitation-associated complication.

Regionalization of neonatal care: benefits, barriers, and beyond.

The goal of regionalization of neonatal care is to improve infant outcomes by directing patients to hospitals where risk-appropriate care is available. Although evidence shows that regionalized, risk-appropriate neonatal care decreases mortality, especially for high-risk infants, the approach and success of regionalization efforts in the U.S.

Measuring quality of care in moderate and late preterm infants.

Objective: To examine quality measures for moderate and late preterm (MLP) infants.

Study Design: By prospectively analyzing Vermont Oxford Network's all NICU admissions database, we adapted Baby-MONITOR, a composite quality measure for extremely/very preterm infants, for MLP infants. We examined correlations between the adapted MLP quality measure (MLP-QM) in MLP infants and Baby-MONITOR in extremely and very preterm infants.