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- W2335276812 abstract "BACKGROUND: Because greater percentages of women deliver at hospitals without high-level NICUs, there is little information on the effect of delivery hospital on the outcomes of premature infants in the past 2 decades, or how these effects differ across states with different perinatal regionalization systems.METHODS: A retrospective population-based cohort study was constructed of all hospital-based deliveries in Pennsylvania and California between 1995 and 2005 and Missouri between 1995 and 2003 with a gestational age between 23 and 37 weeks ( N = 1 328 132). The effect of delivery at a high-level NICU on in-hospital death and 5 complications of premature birth was calculated by using an instrumental variables approach to control for measured and unmeasured differences between hospitals.RESULTS: Infants who were delivered at a high-level NICU had significantly fewer in-hospital deaths in Pennsylvania (7.8 fewer deaths/1000 deliveries, 95% confidence interval [CI] 4.1–11.5), California (2.7 fewer deaths/1000 deliveries, 95% CI 0.9–4.5), and Missouri (12.6 fewer deaths/1000 deliveries, 95% CI 2.6–22.6). Deliveries at high-level NICUs had similar rates of most complications, with the exception of lower bronchopulmonary dysplasia rates at Missouri high-level NICUs (9.5 fewer cases/1000 deliveries, 95% CI 0.7–18.4) and higher infection rates at high-level NICUs in Pennsylvania and California. The association between delivery hospital, in-hospital mortality, and complications differed across the 3 states.CONCLUSIONS: There is benefit to neonatal outcomes when high-risk infants are delivered at high-level NICUs that is larger than previously reported, although the effects differ between states, which may be attributable to different methods of regionalization.* Abbreviations: BPD — : bronchopulmonary dysplasia CI — : confidence interval ICD-9-CM — : International Classification of Diseases, Ninth Revision, Clinical Modification NEC — : necrotizing enterocolitis ROP — : retinopathy of prematurity RR — : risk ratio" @default.
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- W2335276812 date "2012-12-01" @default.
- W2335276812 modified "2023-09-27" @default.
- W2335276812 title "The Differential Impact of Delivery Hospital on the Outcomes of Premature Infants" @default.
- W2335276812 doi "https://doi.org/10.1097/01.ogx.0000425644.18736.91" @default.
- W2335276812 hasPublicationYear "2012" @default.
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