National Vital Statistics System

36. Abnormal conditions of the newborn

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Category: Newborn Information

BC # 54

Definitions, instructions, sources, keywords and abbreviations
Definitions Disorders or significant morbidity experienced by the newborn.
Instructions

Check all boxes that apply.

If none of the conditions apply, check “none of the above.”
Sources See below
Keywords and Abbreviations See below
Assisted ventilation required immediately following delivery
Definitions

Infant given manual breaths for any duration with bag and mask or bag and endotracheal tube within the first several minutes from birth.

Excludes free-flow (blow-by) oxygen only, laryngoscopy for aspiration of meconium, nasal cannula, and bulb suction.
Instructions
Sources 1st Labor delivery summary under – Infant Data or Breathing
Keywords and Abbreviations Bag and mask ventilation

Intubation

Intubation and PPV – Positive pressure ventilation

PPV bag/mask or ET – Positive pressure ventilation via bag, mask, or endotracheal intubation

IPPV bag – Intermittent positive pressure ventilation via bag

IPPV ET – Intermittent positive pressure ventilation via endotracheal intubation

O2 via ET – Oxygen via endotracheal intubation

Oxygen
Assisted ventilation required for more than six hours
Definitions

Infant given mechanical ventilation (breathing assistance) by any method for more than 6 hours.

Includes conventional, high frequency, or continuous positive pressure (CPAP).

Excludes free-flow oxygen only, laryngoscopy for aspiration of meconium, and nasal cannula.
Instructions Count the number of hours of mechanical ventilation given.
Sources 1st  Newborn respiratory care flow sheet
Keywords and Abbreviations If in use for more than 6 hours:

CPAP – Continuous positive airway pressure

IPPV – Intermittent positive pressure ventilation

HFV – High frequency ventilation

IMV – Intermittent mandatory volume ventilation

HFOV – High frequency oscillatory ventilation

IPPV – Intermittent positive pressure ventilation

PIP – Peak inspiratory pressure

PEEP – Positive end expiratory pressure

CMV – Continuous mandatory ventilation

HFPPV – High frequency positive pressure ventilation

HFFI – High frequency flow interruption ventilation

HFJV – High frequency jet ventilation

Inhaled nitric oxide
NICU admission
Definitions

Admission into a facility or unit staffed and equipped to provide continuous mechanical ventilatory support for a newborn.
Instructions

Include NICU admission at any time during the infant’s hospital stay following delivery.

Do not include units that do not provide continuous mechanical ventilation. Do not include well-baby nurseries or special care nurseries (i.e., Level II nursery).

Do not include if the newborn was taken to the NICU for observation but is not admitted to the NICU.
Sources

1st  Labor and delivery summary record under – Disposition under –

  • Intensive care nursery (ICN)
Keywords and Abbreviations

ICN – Intensive care nursery

NICU – Neonatal intensive care unit

PICU – Pediatric intensive care unit
Newborn given surfactant replacement therapy
Definitions

Endotracheal instillation of a surface-active suspension for treating surfactant deficiency due to preterm birth or pulmonary injury resulting in respiratory distress.

Includes both artificial and extracted natural surfactant.
Instructions Check both 1st and 2nd sources before completion.
Sources

1st  Labor and delivery summary under – Neonatal medication

2nd  Newborn medication administration record
Keywords and Abbreviations If given to newborn after birth:

Medications (given to newborn):

  • Surfactant
  • Survanta
  • Exosurf
  • Curosurf
  • Infasurf
Antibiotics received by the newborn for suspected neonatal sepsis
Definitions Any antibacterial drug (penicillin, ampicillin, gentamicin, cefotoxine, etc.) given systemically (intravenous or intramuscular). Does not include antibiotics given to infants who are not suspected of having neonatal sepsis.
Instructions
Sources 1st  Newborn medication administration record
Keywords and Abbreviations Medications (given to newborn for sepsis):
  • Nafcillin, Chloramphenicol
  • Penicillin, Penicillin G
  • Ampicillin, Gentamicin, Kanamycin, Cefotaxime, Cefoxitin, Vancomycin, Acyclovir, Amikacin, Ceftazidime, Ceftriaxone, Cefazolin
Seizure or serious neurologic dysfunction
Definitions

Seizure is any involuntary repetitive, convulsive movement or behavior.

Serious neurologic dysfunction is severe alteration of alertness.

Excludes:

  • Lethargy or hypotonia in the absence of other neurologic findings
  • Symptoms associated with CNS congenital anomalies
Instructions
Sources

1st  Newborn H&P

2nd  Physician progress notes under – Neuro Exam
Keywords and Abbreviations

Seizures

Tonic/Clonic/Clonus

Twitching

Eye rolling

Rhythmic jerking

Hypotonia

Obtundation

Stupor

Coma

HIE – Hypoxic-ischemic encephalopathy

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