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Ohio hospital praised for premature baby survival

Associated Press • Nov 5, 2012 at 6:32 AM

Nearly 90 percent of babies born before 27 weeks gestation — the smallest, sickest infants — are surviving at Nationwide Children's Hospital following an 8-year-old effort to standardize and improve care, said Dr. Edward Shepherd, chief of neonatology at the hospital.

That survival rate is compared to a 78 percent survival rate at the hospital in 2009, which was considered high at the time, according to a recently published study in the Journal of Neonatal-Perinatal Medicine.

The Columbus Dispatch reports (http://bit.ly/SyLv2C) that other recent studies have shown survival rates anywhere between 39 and 70 percent at other hospitals.

Shepherd credits the hospital's success to its small baby program, started in late 2004 to unite doctors, therapists, nurses and others to follow specific protocols likely to help the babies develop normally and go home with their parents.

He said that the guidelines have evolved over time but have consistently improved the likelihood of survival for infants born up to four months early.

Among the guidelines include what is known as "kangaroo care," in which parents hold their babies skin-to-skin to encourage healthy neurological development, among other benefits.

The hospital also limits medical care that could harm the tiny babies' delicate skin and increase the risk of infection and other complications. That includes minimizing the amount of tape applied to the skin, using gentler tape and thoroughly checking the skin for signs of damage.

Before the guidelines, Shepherd said there was a considerable amount of variation in how extremely premature infants were cared for.

"If you have a culture of optimism, of a really solid process, of really careful uniform care, then your babies do better," he said.

Dr. Ed Bell, a professor of pediatrics at the University of Iowa and an expert in extremely premature infants, said that standardization of care is "a potentially very important area that we all need to learn more about that would be very important for the public."

"I don't think we understand very well all the factors that influence survival rates in those babies," he said.

Grandview Heights resident Melissa DeGraw Metz's son Nicholas spent three months at Nationwide Children's after he was born at 24 weeks and weighed just 1 pound, 11 ounces.

"He had everything against him," DeGraw Metz said, who describes his three months in the hospital as a terrifying and hopeful time.

"Through the whole progression, it's like one step forward and two steps back. He'd have a really good couple days, and he'd crash and they'd intubate him again," she said.

Nicholas is now 19 months old and doing well.

"As a parent, you're just helpless, and you have to rely on and put your trust and faith in these doctors and nurses," she said. "And the whole time they had a plan, and they knew what it was.

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