BRIEF RESEARCH REPORT article

Front. Pediatr.

Sec. Neonatology

Volume 13 - 2025 | doi: 10.3389/fped.2025.1570542

This article is part of the Research TopicCare of the extremely preterm infantView all 15 articles

Center-Specific Variation in Outcomes for Extremely Premature, Extremely Low Birth Weight Neonates

Provisionally accepted
Sai Manasa KalyanamSai Manasa Kalyanam1Jordan R. KuiperJordan R. Kuiper2Theodore J. IwashynaTheodore J. Iwashyna3Lindsey KnakeLindsey Knake4Esther LeeEsther Lee5James Lawrence WynnJames Lawrence Wynn6Khyzer B. AzizKhyzer B. Aziz1*
  • 1Department of Pediatrics, Johns Hopkins University, Baltimore, United States
  • 2Department of Environmental and Occupational Health, George Washington University, Washington, D.C., District of Columbia, United States
  • 3Department of Pulmonary and Critical Care Medicine, Johns Hopkins University, Baltimore, United States
  • 4Department of Pediatrics, The University of Iowa, Iowa City, Iowa, United States
  • 5Department of Pediatrics, Rush University, Chicago, Illinois, United States
  • 6Department of Pediatrics, University of Florida, Gainesville, Florida, United States

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Survival rate of neonates born extremely low birth weight (<1000 grams) and extremely preterm (<29 gestational age) have significantly improved with advances in neonatal care. Despite such advances, outcomes vary widely across neonatal intensive care units due to differences in care practices and patient population. In this study, we examined 1627 extremely low birth weight and extremely preterm infants admitted to three NICUs across the United States between 2013 and 2023. We evaluated survival and severe intraventricular hemorrhage using statistical models that were adjusted for maternal and neonatal characteristics. Significant differences in outcomes were observed between the centers. These differences were associated with variations in care practices, including resuscitation decisions for the infants. Despite these differences, all centers achieved survival without SIVH for a substantial number of infants, annually. These findings emphasize the need for evidencebased practice-sharing and improvements to ensure better and more consistent care.

Keywords: Neonatal Care 1, Extremely Premature 2, Extremely Low Weight 3, Center Specific Variation 4, Neonatal Practices 5

Received: 03 Feb 2025; Accepted: 31 May 2025.

Copyright: © 2025 Kalyanam, Kuiper, Iwashyna, Knake, Lee, Wynn and Aziz. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Khyzer B. Aziz, Department of Pediatrics, Johns Hopkins University, Baltimore, United States

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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