{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T16:51:44Z","timestamp":1771260704920,"version":"3.50.1"},"reference-count":34,"publisher":"Georg Thieme Verlag KG","issue":"06","funder":[{"DOI":"10.13039\/501100000031","name":"Institute of Human Development, Child and Youth Health","doi-asserted-by":"crossref","award":["PBN 150642"],"award-info":[{"award-number":["PBN 150642"]}],"id":[{"id":"10.13039\/501100000031","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Perinatol"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:p>\n            Objective\u2003This study aimed to assess if 24-hour in-house neonatologist (NN) coverage is associated with delivery room (DR) resuscitation\/stabilization and outcomes among inborn infants &lt;29 weeks' gestational age (GA).<\/jats:p><jats:p>\n            Study design\u2003Survey-linked cohort study of 2,476 inborn infants of 23 to 28 weeks' gestation, admitted between 2014 and 2015 to Canadian Neonatal Network Level-3 neonatal intensive care units (NICUs) with a maternity unit. Exposures were classified using survey responses based on the most senior provider offering 24-hour in-house coverage: NN, fellow, and no NN\/fellow. Primary outcome was death and\/or major morbidity (bronchopulmonary dysplasia, severe neurological injury, late-onset sepsis, necrotizing enterocolitis, and retinopathy of prematurity). Multivariable logistic regression analysis was used to assess the association between exposures and outcomes and adjust for confounders.<\/jats:p><jats:p>\n            Results\u2003Among the 28 participating NICUs, most senior providers ensuring 24-hour in-house coverage were NN (32%, 9\/28), fellows (39%, 11\/28), and no NN\/fellow (29%, 8\/28). No NN\/fellow coverage and 24-hour fellow coverage were associated with higher odds of infants receiving DR chest compressions\/epinephrine compared with 24-hour NN coverage (adjusted odds ratio [aOR]\u2009=\u20094.72, 95% confidence interval [CI]: 2.12\u201310.6 and aOR\u2009=\u20093.33, 95% CI: 1.44\u20137.70, respectively). Rates of mortality\/major morbidity did not differ significantly among the three groups: NN, 63% (249\/395 infants); fellow, 64% (1092\/1700 infants); no NN\/fellow, 70% (266\/381 infants).<\/jats:p><jats:p>\n            Conclusion\u200324-hour in-house NN coverage was associated with lower rates of DR chest compressions\/epinephrine. There was no difference in neonatal outcomes based on type of coverage; however, further studies are needed as ecological fallacy cannot be ruled out.<\/jats:p><jats:p>\n            Key Points\n          <\/jats:p>","DOI":"10.1055\/a-1772-4637","type":"journal-article","created":{"date-parts":[[2022,2,16]],"date-time":"2022-02-16T01:37:01Z","timestamp":1644975421000},"page":"747-755","source":"Crossref","is-referenced-by-count":3,"title":["Association of 24-Hour In-house Neonatologist Coverage with Outcomes of Extremely Preterm Infants"],"prefix":"10.1055","volume":"41","author":[{"given":"Anthony","family":"Debay","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prakesh","family":"Shah","sequence":"additional","affiliation":[{"name":"Departement of Pediatrics, Toronto University, Toronto, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abhay","family":"Lodha","sequence":"additional","affiliation":[{"name":"Departement of Pediatrics, University of Calgary, Calgary, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandesh","family":"Shivananda","sequence":"additional","affiliation":[{"name":"Departement of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Redpath","sequence":"additional","affiliation":[{"name":"Departement of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Seshia","sequence":"additional","affiliation":[{"name":"Departement of Pediatrics, University of Manitoba, Winnipeg, Manitoba, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jon","family":"Dorling","sequence":"additional","affiliation":[{"name":"Departement of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anie","family":"Lapointe","sequence":"additional","affiliation":[{"name":"Departement of Pediatrics, Universit\u00e9 de Montr\u00e9al, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rody","family":"Canning","sequence":"additional","affiliation":[{"name":"Departement of Pediatrics, Moncton Hospital, Moncton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lannae","family":"Strueby","sequence":"additional","affiliation":[{"name":"Departement of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Beltempo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the Canadian Neonatal Network Investigators","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,4,18]]},"reference":[{"issue":"09","key":"ref1","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1001\/jama.2010.1226","article-title":"Perinatal regionalization for very low-birth-weight and very preterm infants: a meta-analysis","volume":"304","author":"S M Lasswell","year":"2010","journal-title":"JAMA"},{"issue":"10","key":"ref2","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1001\/jama.2015.10244","article-title":"Trends in care practices, morbidity, and mortality of extremely preterm neonates, 1993\u20132012","volume":"314","author":"B J Stoll","year":"2015","journal-title":"JAMA"},{"issue":"04","key":"ref3","doi-asserted-by":"crossref","first-page":"E81","DOI":"10.1503\/cmaj.190940","article-title":"Outcomes and care practices for preterm infants born at less than 33 weeks' gestation: a quality-improvement study","volume":"192","author":"S K Lee","year":"2020","journal-title":"CMAJ"},{"issue":"06","key":"ref4","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1001\/jama.1985.03350300087026","article-title":"The regionalization of perinatal services. 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Therapeutic decisions based upon clinical staging","volume":"187","author":"M J Bell","year":"1978","journal-title":"Ann Surg"},{"issue":"04","key":"ref33","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1093\/aje\/kwf215","article-title":"Statistical analysis of correlated data using generalized estimating equations: an orientation","volume":"157","author":"J A Hanley","year":"2003","journal-title":"Am J Epidemiol"},{"issue":"01","key":"ref34","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1097\/00001648-199001000-00010","article-title":"No adjustments are needed for multiple comparisons","volume":"1","author":"K J Rothman","year":"1990","journal-title":"Epidemiology"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.resuscitation.2017.11.045","article-title":"24\/7 in house attending staff coverage improves neonatal short-term outcomes: a retrospective study","volume":"122","author":"B Bensouda","year":"2018","journal-title":"Resuscitation"}],"container-title":["American Journal of Perinatology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-1772-4637.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T10:17:50Z","timestamp":1730801870000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-1772-4637"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,15]]},"references-count":34,"journal-issue":{"issue":"06","published-online":{"date-parts":[[2024,4,10]]},"published-print":{"date-parts":[[2024,4]]}},"URL":"https:\/\/doi.org\/10.1055\/a-1772-4637","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0735-1631","1098-8785"],"issn-type":[{"value":"0735-1631","type":"print"},{"value":"1098-8785","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,2,15]]},"published":{"date-parts":[[2022,2,15]]}}}