@article{Greenbury:2021:10.1136/bmjopen-2021-054410,
author = {Greenbury, SF and Longford, N and Ougham, K and Angelini, ED and Battersby, C and Uthaya, S and Modi, N},
doi = {10.1136/bmjopen-2021-054410},
journal = {BMJ Open},
title = {Changes in neonatal admissions, care processes and outcomes in England and Wales during the COVID-19 pandemic: a whole population cohort study},
url = {http://dx.doi.org/10.1136/bmjopen-2021-054410},
volume = {11},
year = {2021}
}

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TY  - JOUR
AB  - Objectives: The COVID-19 pandemic instigated multiple societal and healthcare interventions with potential to affect perinatal practice. We evaluated population-level changes in preterm and full-term admissions to neonatal units, care processes and outcomes.Design: Observational cohort study using the UK National Neonatal Research Database.Setting: England and Wales.Participants: Admissions to National Health Service neonatal units from 2012 to 2020.Main outcome measures: Admissions by gestational age, ethnicity and Index of Multiple Deprivation, and key care processes and outcomes.Methods: We calculated differences in numbers and rates between April and June 2020 (spring), the first 3 months of national lockdown (COVID-19 period), and December 2019–February 2020 (winter), prior to introduction of mitigation measures, and compared them with the corresponding differences in the previous 7 years. We considered the COVID-19 period highly unusual if the spring–winter difference was smaller or larger than all previous corresponding differences, and calculated the level of confidence in this conclusion.Results: Marked fluctuations occurred in all measures over the 8 years with several highly unusual changes during the COVID-19 period. Total admissions fell, having risen over all previous years (COVID-19 difference: −1492; previous 7-year difference range: +100, +1617; p<0.001); full-term black admissions rose (+66; −64, +35; p<0.001) whereas Asian (−137; −14, +101; p<0.001) and white (−319; −235, +643: p<0.001) admissions fell. Transfers to higher and lower designation neonatal units increased (+129; −4, +88; p<0.001) and decreased (−47; −25, +12; p<0.001), respectively. Total preterm admissions decreased (−350; −26, +479; p<0.001). The fall in extremely preterm admissions was most marked in the two lowest socioeconomic quintiles.Conclusions: Our findings indicate substantia
AU  - Greenbury,SF
AU  - Longford,N
AU  - Ougham,K
AU  - Angelini,ED
AU  - Battersby,C
AU  - Uthaya,S
AU  - Modi,N
DO  - 10.1136/bmjopen-2021-054410
PY  - 2021///
SN  - 2044-6055
TI  - Changes in neonatal admissions, care processes and outcomes in England and Wales during the COVID-19 pandemic: a whole population cohort study
T2  - BMJ Open
UR  - http://dx.doi.org/10.1136/bmjopen-2021-054410
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000703621500012&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/92293
VL  - 11
ER  - 

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