A standardized implementation of multicenter quality improvement program of very low birth weight newborns could significantly reduce admission hypothermia and improve outcomes

Table 5 Unadjusted and adjusted relative risk of outcomes for VLBW infants during post-QI phase with reference to pre-QI phase

Adverse outcomes	Pre-QI phase (n = 270)	Post-QI phase (n = 480)
Adverse outcomes	Pre-QI phase (n = 270)	Unadjusted RR (95% CI)	^bAdjusted RR (95% CI)
Hypothermia	1.00	0.74 (0.70, 0.79)	0.74 (0.63, 0.87)
Moderate/severe hypothermia	1.00	0.44 (0.37, 0.51)	0.44 (0.35, 0.54)
Composite outcome	1.00	0.89 (0.73, 1.08)	0.89 (0.69, 1.14)
Mortality	1.00	0.25 (0.13, 0.48)	0.26 (0.13, 0.50)
LOS	1.00	0.66 (0.52, 0.84)	0.66 (0.50, 0.87)
NEC (Bell stage ≥ 2)	1.00	0.52 (0.25, 1.10)	0.54 (0.25, 1.15)
IVH or PVL (Papile grade 3/4)	1.00	1.60 (0.64, 4.00)	1.77 (0.69, 4.51)
Pulmonary hemorrhage	1.00	0.60 (0.31, 1.14)	0.61 (0.32, 1.20)
BPD (moderate/severe)	1.00	1.10 (0.71, 1.71)	1.11 (0.70, 1.78)
ROP (grade 3/4)	1.00	1.50 (0.40, 5.62)	1.49 (0.39, 5.62)

Abbreviations: QI Quality improvement, RR Risk ratio, CI Confidence interval, BPD Bronchopulmonary dysplasia, IVH Intraventricular haemorrhage, NEC Necrotizing enterocolitis, LOS Late-onset neonatal sepsis, ROP Retinopathy of prematurity, GA Gestational age, BW Birth weight, SGA Small for gestational age
^b Adjusted for BW, GA, SGA, Apgar score at 5 min < 7 by Poisson regression analysis

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