Quantifying the impact of centralised neonatal care following interhospital transfer of preterm infants on families.

Aim: Evaluate the additional burden of centralised neonatal care on families of extremely preterm infants cared for away from their planned hospital of birth.

Methods: Retrospective cohort study using national data for infants 23 to 27 weeks of gestation admitted for neonatal care from 2011 to 2016. The number of transfers on the first day of life (potential maternal-infant separation), time away from the maternal booking hospital (BH) and distance from the maternal residence were quantified.

Results: Of 14 719 included infants, 2803 (19%) underwent postnatal transfer on the first day of life. A total of 8622 (59%) infants were cared for away from their BH for a median of 39 days (interquartile range [IQR] 15-69), 30% spending >60 days away over a median of two episodes (range 1-12). Median return road travelling distances for parents to their local BH was 13 km (IQR 8-26), but this increased to 74 km (IQR 32-148) for those cared for in a non-BH.

Conclusion: Centralised neonatal care improves infant outcomes but introduces additional burdens on the families of extremely preterm infants cared for away from their BH. Additional support, including accommodation and financial aid, could help minimise the impact on these families, facilitate family integrated care and improve parental wellbeing.