Opportunities for maternal transport for delivery of very low birth weight infants

• Published in: Journal of perinatology Vol. 37; no. 1; pp. 32 - 35
• Main Authors: Robles, D, Blumenfeld, Y J, Lee, H C, Gould, J B, Main, E, Profit, J, Melsop, K, Druzin, M
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01-01-2017; Nature Publishing Group
• Subjects: 692/499; 692/699/2732; 692/700/228; Babies; Birth Rate; Birth weight; Birth weight, Low; Births; California - epidemiology; Care and treatment; Childbirth; Cohort analysis; Collaboration; Delivery (Childbirth); Female; Forecasts and trends; Gestational age; Gynecology; Health aspects; Hospitals - classification; Hospitals - statistics & numerical data; Humans; Infant; Infant Mortality; Infant, Newborn; Infant, Very Low Birth Weight; Length of stay; Length of Stay - statistics & numerical data; Low birth weight; Male; Management; Maternal health services; Medicine; Medicine & Public Health; Methods; Obstetrics; original-article; Pediatric Surgery; Pediatrics; Perinatal Care - economics; Pregnancy; Pregnancy, Multiple; Retrospective Studies; Transportation of Patients; California; United States; United States > US; San Francisco California
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/jp.2016.174

Objective:
To assess frequency of very low birth weight (VLBW) births at non-level III hospitals.
Study Design:
Retrospective cohort study using linked California birth certificate and discharge data of 2008 to 2010 for deliveries of singleton or first-born infant of multiple gestations with birth weight 400 to 1500 g. Delivery rates by neonatal level of care were obtained. Risk of delivery at non-level III centers was estimated in univariable and multivariable models.
Results:
Of the 1 508 143 births, 13 919 (9.2%) were VLBW; birth rate at non-level III centers was 14.9% (8.4% in level I and 6.5% in level II). Median rate of VLBW births was 0.3% (range 0 to 4.7%) annually at level I and 0.5% (range 0 to 1.6%) at level II hospitals. Antepartum stay for >24 h occurred in 14.0% and 26.9% of VLBW births in level I and level II hospitals, respectively.
Conclusion:
Further improvement is possible in reducing VLBW infant delivery at suboptimal sites, given the window of opportunity for many patients.