Recent Research Publications- January 2022
Cardiorespiratory management of infants born at 22 weeks' gestation: The Iowa approach.
Dagle JM, Rysavy MA, Colaizy TT, Elgin TG, Giesinger RE, McElroy SJ, Harmon HM, Klein JM, McNamara PJ, Rabe GK, Bell EF, Thomas BA, Bischoff AR, Rios DR, Lindower JB, Bermick JR, Lee SS, Wong SW, Roghair RD, Morgan-Harris AT, Niwas R, Arikat S, Boly TJ, Segar JL.
Semin Perinatol. 2021 Nov 10:151545.
The approach to clinical care of infants born at 22 weeks' gestation must be consistent and well-designed if optimal results are to be expected. Publications from several international centers have demonstrated that, although there may be variance in aspects of care in this vulnerable population, treatment should be neither random nor inconsistent. In designing a standardized approach, careful attention should be paid to the unique anatomy, physiology, and biochemistry of this vulnerable patient population. Emerging evidence, suggesting a link between cardiopulmonary health and longer-term sequela, highlights the importance of understanding the relationship between cardiorespiratory illnesses of the 22-week infant, treatments provided, and subsequent cardiopulmonary development. In this review we will provide an overview to our approach to cardiopulmonary assessment and treatment, with a particular emphasis on the importance of early recognition of atypical phenotypes, timely interventions with evidence-based treatments, and longitudinal monitoring.
Carrel M, Keino BC, Ryckman KK,
J Rural Health. 2022 Jan 3.
Purpose: Continued closure of rural hospitals and labor & delivery units can impact timely access to care. Iowa has lost over a quarter of its labor & delivery units in the previous decade. Calculating how travel times to labor & delivery services have changed, and where in the state the largest travel times take place, are important for understanding access to this critical service.
Methods: Using parental address and facility location from birth certificate data in Iowa from 2013 to 2019, travel times to birth facility are assessed for rural, micropolitan, and metropolitan parents, as well as for complicated versus noncomplicated births and Medicaid versus non-Medicaid recipients.
Findings: Parts of the state have travel times that are consistently greater than 30 minutes over the duration of the study. The largest increases in travel times are found among micropolitan residents, particularly those experiencing complicated births. Travel times are consistently the longest for rural residents but increased only slightly over the study time period.
Conclusions: These findings suggest that access to hospital-based obstetric care is most changed for residents of small towns rather than rural or larger city residents.