Format

Send to

Choose Destination
Am J Obstet Gynecol. 1998 Jan;178(1 Pt 1):131-5.

Changing patterns in regionalization of perinatal care and the impact on neonatal mortality.

Author information

1
Perinatal Center, Saint Luke's Hospital of Kansas City, Kansas City, MO 64111, USA.

Abstract

OBJECTIVE:

Our goal was to study changing patterns of low-birth-weight outcome over the past decade as deregionalized perinatal care has occurred.

STUDY DESIGN:

Live births and neonatal mortality for two 5-year periods (1982 to 1986 vs 1990 to 1994) were calculated by hospital of delivery in the state of Missouri. Self-designated level of perinatal care was contrasted with number of deliveries and nursery census to evaluate outcome. Regression models were constructed to compare outcome between levels of care.

RESULTS:

There has been a significant shift of deliveries into self-designated level II and III perinatal centers. However, this is largely a result of redesignation of care rather than an actual increase in acuity or census. The relative risk of neonatal mortality for very-low-birth-weight infants is 2.28 in level II centers compared with level III centers, and is unchanged (2.57) from 10 years earlier. Nearly 14% of very-low-birth-weight deliveries still occur at non-level III centers.

CONCLUSION:

Changing patterns of perinatal regionalization have not improved outcome for inborn infants < 1500 gm except in level III centers. Attempts should be made to deliver very-low-birth-weight infants in level III centers.

PMID:
9465816
DOI:
10.1016/s0002-9378(98)70639-8
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center