Abstract
The successful realization of efficient neonatal transport is central to the regionalization of high-risk perinatal healthcare. Environmental factors such as weather conditions have the potential to impact transport services covering large temperate climatic zones. Our objective was to compare neonatal transport duration and relevant neonatal outcomes during winter versus summer seasons in distinct transport zones. This retrospective cohort study included newborns transported within Southwestern Ontario between January 2014 to December 2022. The serviced clinical network was divided into 4 zones based on geographical location. Transport details, patient baseline demographics, Transport Risk Index of Physiologic Stability V2 (TRIPS-II) scores, and clinically relevant outcomes were recorded. Winter (November-March) versus summer (May-September) parameters were compared within each zone. 960 transports were analyzed; 503 in summer, and 457 in winter. Baseline demographic characteristics were comparable between seasons within zones. In Zone 1, net transport time (minutes) was longer in winter versus summer (p = .019). In Zone 2, transport times were comparable; however, speed (km/min) was slower in winter versus summer (p=0.020). In Zone 3 (the Snow Belt), mean (SD) net transport times were approximately 60 minutes longer in winter versus summer [438.2(93.0) vs. 377.3(104.0), p < .001]. In Zone 4, transport times were similar between seasons. TRIPS-II scores, mortality, and major morbidity rates were comparable between seasons across all zones. This large study showed that while neonatal transport services were significantly impacted in the winter, there were no negative effects on post-transport stability, mortality, or major morbidity. Evaluation of this data might inform future service modelling.
Keywords
Main Subjects
)