465 - Impact of Weather Conditions on Neonatal Transport: A Retrospective Cohort Study

Poster Number: 465
Publication Number: 465.2977

Background: An efficient neonatal transport team is central to effective regionalization of high-risk perinatal health care. Environmental factors, such as weather conditions, have potential impact on transport services covering wide geographic areas located in temperate climatic zones.

Objective: To compare neonatal transport duration and relevant neonatal outcomes during summer vs. winter seasons.

Design/Methods: This was a retrospective cohort study of newborns transported within Southwestern Ontario between January 2018 to December 2022. The clinical network serviced was divided into 4 distinct geographical zones, and transport details within each zone were recorded. Baseline demographic factors, along with clinically relevant outcomes, such as Transport Risk Index of Physiologic Stability (TRIPS) Score, mortality, and intraventricular hemorrhage (IVH) in neonates < 32 weeks, were recorded. Parameters within each zone were then compared in winter (November to March) vs. summer (May to September). Means and standard deviations (SD), independent t-tests, frequencies, and chi-square tests were used, as appropriate. P-values < 0.05 were considered statistically significant.

Results: Our study analyzed 960 transport runs: 503 in summer and 457 in winter. Baseline demographic characteristics, mode of transport and transport distances are summarized in Table1. In Zone 1, average distance traversed was 52 km, and mean (SD) net transport time (minutes) was longer in winter vs. summer [200.7 (57.0) vs. 215.5 (65.0), p=0.019]. In Zone 2, average distance traversed was 144 km and transport times were similar, but speed (km/min) was slower in winter vs. summer [0.58 (0.10) vs. 0.63 (0.20), p=0.020]. In Zone 3 (the snowbelt), average distance traversed was 188 km; transport times (minutes) were longer in winter vs. summer [438.2 (93.0) vs. 377.3 (104.0), p< 0.001]. Lastly, in Zone 4, average distance traversed was 1195.75 km; transport times were similar between seasons [747.0 (253.0) vs. 712.6 (212.0), p=0.331]. Mortality rates and IVH rates in neonates < 32 weeks were similar between seasons across all zones. Post transport TRIPS scores were comparable in Zones 1, 2 and 4. In Zone 3, post-transport TRIP score was lower in winter vs. summer [6.6 (10.6) vs. 11.5 (10.5),p=0.012].

Conclusion(s): This large study showed that within 2 of the 4 pre-defined geographic zones, time needed to complete neonatal transport was significantly longer during winter but without any negative impact on post-transport stability, mortality, or major morbidity. Evaluation of this data might inform future service modelling.