title: Perinatal health services organization for preterm births: a multinational comparison.
abstract: To explore population characteristics, organization of health services and comparability of available information for very low birth weight or very preterm neonates born before 32 weeks' gestation in 11 high-income countries contributing data to the International Network for Evaluating Outcomes of Neonates (iNeo).
  
  
  
  We obtained population characteristics from public domain sources, conducted a survey of organization of maternal and neonatal health services and evaluated the comparability of data contributed to the iNeo collaboration from Australia, Canada, Finland, Israel, Italy, Japan, New Zealand, Spain, Sweden, Switzerland and UK.
  
  
  
  All countries have nationally funded maternal/neonatal health care with >90% of women receiving prenatal care. Preterm birth rate, maternal age, and neonatal and infant mortality rates were relatively similar across countries. Most (50 to >95%) between-hospital transports of neonates born at non-tertiary units were conducted by designated transport teams; 72% (8/11 countries) had designated transfer and 63% (7/11 countries) mandate the presence of a physician. The capacity of 'step-down' units varied between countries, with capacity for respiratory care available in <10% to >75% of units. Heterogeneity in data collection processes for benchmarking and quality improvement activities were identified.
  
  
  
  Comparability of healthcare outcomes for very preterm low birth weight neonates between countries requires an evaluation of differences in population coverage, healthcare services and meta-data.
authors.affiliation: Maternal-Infant Care Research Centre, Mount Sinai Hospital, 700 University Avenue, Toronto, ON, Canada.
authors.forename: L E
authors.initials: LE
authors.lastname: Kelly
authors.affiliation: Maternal-Infant Care Research Centre, Mount Sinai Hospital, 700 University Avenue, Toronto, ON, Canada.|Department of Pediatrics, Mount Sinai Hospital and University of Toronto, 600 University Avenue, Toronto, ON, Canada.
authors.forename: P S
authors.initials: PS
authors.lastname: Shah
authors.affiliation: Department of Pediatrics/Neonatal Services, Swedish Neonatal Quality Register, Umeå University Hospital, Umeå, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Håkansson
authors.affiliation: Neonatal Research Network Japan, Maternal and Perinatal Center, Tokyo Women's Medical University, Shinjuku, Tokyo, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Kusuda
authors.affiliation: Department of Neonatology, Swiss Neonatal Network, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 10, Switzerland, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Adams
authors.affiliation: Maternal-Infant Care Research Centre, Mount Sinai Hospital, 700 University Avenue, Toronto, ON, Canada.|Department of Pediatrics, Mount Sinai Hospital and University of Toronto, 600 University Avenue, Toronto, ON, Canada.
authors.forename: S K
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Department of Pediatrics/Neonatal Services, Swedish Neonatal Quality Register, Umeå University Hospital, Umeå, Sweden.
authors.forename: G
authors.initials: G
authors.lastname: Sjörs
authors.affiliation: Spanish Neonatal Network, Health Research Institute La Fe, Valencia, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Vento
authors.affiliation: Unit of Epidemiology, TIN Toscane Online, Meyer Children's University Hospital, Regional Health Agency, Florence, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Rusconi
authors.affiliation: Department of Pediatrics, Finnish Medical Birth Register and Register of Congenital Malformations, Turku University Hospital, Kiinamyllynkatu 4-8, Turku, Finland.
authors.forename: L
authors.initials: L
authors.lastname: Lehtonen
authors.affiliation: Israel Neonatal Network, Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Centre, Tel Hashomer, Israel.
authors.forename: B
authors.initials: B
authors.lastname: Reichman
authors.affiliation: Department of Paediatrics, Australia and New Zealand Neonatal Network, University of Otago, Christchurch, New Zealand.
authors.forename: B A
authors.initials: BA
authors.lastname: Darlow
authors.affiliation: National Perinatal Epidemiology and Statistic Unit, Australian and New Zealand Neonatal Network, Royal Hospital for Women, University of New South Wales, Randwick, NSW, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Lui
authors.affiliation: Spanish Neonatal Network, Health Research Institute La Fe, Valencia, Spain.
authors.forename: L S
authors.initials: LS
authors.lastname: Feliciano
authors.affiliation: Division of Pediatrics and Neonatology, Ospedale Versilia, Viareggio, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Gagliardi
authors.affiliation: Department of Neonatology, Swiss Neonatal Network, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 10, Switzerland, Switzerland.
authors.forename: D
authors.initials: D
authors.lastname: Bassler
authors.affiliation: Neonatal Data Analysis Unit, Section of Neonatal Medicine, Department of Medicine, UK Neonatal Collaborative, Imperial College London, Chelsea and Westminster Hospital Campus, London, UK.
authors.forename: N
authors.initials: N
authors.lastname: Modi
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D038622:Internationality; D008297:Male; D018743:Perinatal Care / Q000458:organization & administration / Q000592:standards*; D011247:Pregnancy; D011272:Pregnancy, Multiple; D047928:Premature Birth / Q000453:epidemiology; D011295:Prenatal Care; D058996:Quality Improvement; D014187:Transportation of Patients