NEURODEVELOPMENTAL OUTCOMES OF PRETERM INFANTS <29 WEEKS GESTATION BASED ON LOCATION OF BIRTH IN CANADA
Bibliographic record
Abstract
BACKGROUND: Studies have reported a higher risk of adverse neonatal outcomes in outborn infants compared to those born within a tertiary center; however data on neurodevelopmental outcomes are limited. OBJECTIVES: To compare mortality and neurodevelopmental outcomes of preterm infants of <29 weeks gestation born outside a tertiary care center with those born at tertiary centers. DESIGN/METHODS: Data were obtained from the Canadian Neonatal Network and Canadian Neonatal Follow-up Network databases for infants of <29 weeks gestation and admitted to a tertiary NICU between April 2009 and September 2011 who underwent a standardized assessment at 18-21 months age, including history, physical and neurological exams, and Bayley-III assessment. Outcomes of death or significant neurodevelopmental impairment (sNDI), death or any neurodevelopmental impairment (NDI) and individual components of assessment were compared between outborn and inborn infants after adjustment for confounders (GA, SGA, multiples, antenatal steroids, SNAPII score and mode of delivery). RESULTS: Of a total of 2951 infants, 2478 (84%) were inborn and 473 (16%) were outborn. Mean BW (897g vs 940g), receipt of antenatal steroids (94% vs 54%), SGA (9.4% vs 5.3%), caregiver college education (55% vs 44%), differed between inborn and outborn respectively. The median SNAP II score and Apgar at 5 min were higher in inborn whereas TRIPS score on admission was higher for outborn. Adjusted OR for neurodevelopmental outcomes are reported in Table. CONCLUSION: Mortality or adverse neurodevelopmental outcomes are significantly higher in preterm infants <29 weeks GA born outside of a tertiary care center.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".