Neuroprotection care bundle implementation is associated with improved long-term neurodevelopmental outcomes in extremely premature infants

Objective To study the impact of an evidence-based neuroprotection care (NPC) bundle on long-term neurodevelopmental impairment (NDI) in infants born extremely premature. Study design An NPC bundle targeting predefined risk factors for acute brain injury in extremely preterm infants was implemented. We compared the incidence of composite outcome of death or severe neurodevelopmental impairment (sNDI) at 21 months adjusted age pre and post bundle implementation. Results Adjusting for confounding factors, NPC bundle implementation associated with a significant reduction in death or sNDI (aOR, 0.34; 95% CI 0.17–0.68; P = 0.002), mortality (aOR, 0.31; 95% CI (0.12–0.79); P = 0.015), sNDI (aOR, 0.37; 95% CI: 0.12–0.94; P = 0.039), any motor, language, or cognitive composite score <70 (aOR, 0.48; 95% CI: 0.26–0.90; P = 0.021). Conclusion Implementation of NPC bundle targeting predefined risk factors is associated with a reduction in mortality or sNDI in extremely preterm infants.