Recent changes in delivery site of low-birth-weight infants in Washington: Impact on birth weight-specific mortality

doi:10.1016/0002-9378(95)90653-3

American Journal of Obstetrics and Gynecology

Volume 173, Issue 5, November 1995, Pages 1585-1592

https://doi.org/10.1016/0002-9378(95)90653-3 Get rights and content

Abstract

OBJECTIVES: Our purpose was to ascertain whether the proportion of low-birth-weight infants delivered in Washington at tertiary hospitals changed between 1980 and 1991 and whether mortality differed by level of birth hospital.

STUDY DESIGN: A retrospective cohort study was performed of 500 to 2499 gm infants both to Washington residents between 1980 and 1991 (n = 43,228).

RESULTS: Overall, the percentage of low-birth-weight infants born at tertiary centers rose from 1980 to 1982 through 1986 to 1988 and subsequently declined significantly. Among infants weighing <2000 gm nontertiary delivery was associated with greater potentially preventable mortality (500 to 999 gm, relative risk 1.5, 95% confidence interval 1.3 to 1.8; 1000 to 1499 gm, relative risk 2.1, 95% confidence interval 1.3 to 3.3; 1500 to 1999 gm, relative risk 1.6, 95% confidence interval 1.0 to 2.6). Nontertiary delivery of 2000 to 2499 gm infants was associated with lower overall mortality (relative risk 0.5, 95% confidence interval 0.3 to 0.8), but higher-risk deliveries in this birth weight range were apparently concentrated at tertiary hospitals.

CONCLUSIONS: In light of the apparent benefit of tertiary center birth for infants weighing <2000 gm, the possible erosion of effective regionalized perinatal care networks should be monitored closely.

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Citation Excerpt :
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^☆: Supported in part by grant No. MCJ-9043 from the Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Services Administration, Department of Health and Human Services.

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ObstetricsRecent changes in delivery site of low-birth-weight infants in Washington: Impact on birth weight-specific mortality☆

Abstract

Perinatal care: the threat of deregionalization

Pediatr Ann

Analysis of a maternal transport service within a perinatal region

Am J Perinatol

Maternal transport of patients with advanced cervical dilatation—to fly or not to fly?

Obstet Gynecol

Outcomes of regionalized perinatal care in Washington state

West J Med

The relation of obstetrical volume and nursery level to perinatal mortality

Am J Public Health

Interhospital referral of high-risk newborns in a rural regional perinatal program

J Perinatol

Newborn intensive car and neonatal mortality in low-birth-weight infants

N Engl J Med

Obstetrics
Recent changes in delivery site of low-birth-weight infants in Washington: Impact on birth weight-specific mortality☆