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<jats:sec><jats:title>Objective</jats:title><jats:p>There is evidence that birth and care in a maternity service associated with a neonatal intensive care unit (NICU) is associated with improved survival in preterm babies born at <jats:underline><</jats:underline>27 weeks of gestation. We conducted a systematic review to address whether similar gains manifested in babies born between 27+0 and 31+6 weeks (hereafter 27 and 31 weeks) of gestation, or in those with a birth weight between 1000 and 1500 g.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We searched Embase, Medline and CINAHL databases for studies comparing outcomes for babies born between 27 and 31 weeks or between 1000 and 1500 g birth weight, based on designation of the neonatal unit where the baby was born or subsequently cared for (NICU vs non-NICU setting). A modified QUIPS (QUality In Prognostic Studies) tool was used to assess quality.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Nine studies compared outcomes for babies born between 27 and 31 weeks of gestation and 11 studies compared outcomes for babies born between 1000 and 1500 g birth weight. Heterogeneity in comparator groups, birth locations, gestational age ranges, timescale for mortality reporting, and description of morbidities facilitated a narrative review as opposed to a meta-analysis.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>Due to paucity of evidence, significant heterogeneity and potential for bias, we were not able to answer our question—does place of birth or care affect outcomes for babies born between 27 and 31 weeks? This supports the need for large-scale research to investigate place of birth and care for babies born in this gestational age range.</jats:p></jats:sec>

Original publication

DOI

10.1136/bmjpo-2019-000583

Type

Other

Publisher

BMJ

Publication Date

18/03/2020

Volume

4

Pages

e000583 - e000583