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Worse Outcomes for Mother-Infant Pairs in Separate ICUs

Worse Outcomes for Mother-Infant Pairs in Separate ICUs

Concurrent admission linked to increased separation; elevated maternal, neonatal mortality

WEDNESDAY, Oct. 24 (HealthDay News) -- Concurrent admission of a mother and her newborn to separate intensive care units (co-ICU) is associated with increased prevalence of mother-infant separation because of interfacility transfer, and with elevated mortality for both, according to a study published online Oct. 22 in CMAJ, the journal of the Canadian Medical Association.

Joel G. Ray, M.D., from St. Michael's Hospital at the University of Toronto, and colleagues examined the prevalence and predictors of mother-infant separation and mortality related to co-ICU admissions using data from 1,216 mother-infant pairs that had co-ICU admission; 897 live births with maternal admission only; 123,236 with neonatal ICU (NICU) admission only; and 898,629 with no ICU admission.

The researchers found that the prevalence of co-ICU admissions was 1.2 per 1,000 live births and was elevated compared with maternal ICU admissions (0.9 per 1,000). In the co-ICU group, maternal-newborn separation due to interfacility transfer was 30.8 times more common than in the no-ICU group, and exceeded the prevalence in the maternal ICU and NICU groups. Relative to the no-ICU group (0.7 per 1,000), short-term infant mortality was higher in the co-ICU group (18.1 per 1,000 live births; maternal age-adjusted hazard ratio [HR], 27.8) than in the NICU group (7.6 per 1,000; HR, 11.5). Higher short-term maternal mortality was also seen in the co-ICU group (15.6 per 1,000; HR, 328.7), compared with the maternal ICU group (6.7 per 1,000; HR, 140.0) or the NICU group (0.2 per 1,000; HR, 4.6).

"Mother-infant pairs in the co-ICU group had the highest prevalence of separation due to interfacility transfer and the highest mortality compared with those in the maternal ICU and NICU groups," the authors write.

Abstract (http://www.cmaj.ca/content/early/2012/10/22/cmaj.121283 )Full Text (http://www.cmaj.ca/content/early/2012/10/22/cmaj.121283.full.pdf+html )