Level and volume of neonatal intensive care and mortality in very-low-birth-weight infants.

  title={Level and volume of neonatal intensive care and mortality in very-low-birth-weight infants.},
  author={Ciaran S. Phibbs and Laurence C. Baker and Aaron B. Caughey and Beate H. Danielsen and Susan K. Schmitt and Roderic H. Phibbs},
  journal={The New England journal of medicine},
  volume={356 21},
BACKGROUND There has been a large increase in both the number of neonatal intensive care units (NICUs) in community hospitals and the complexity of the cases treated in these units. We examined differences in neonatal mortality among infants with very low birth weight (below 1500 g) among NICUs with various levels of care and different volumes of very-low-birth-weight infants. METHODS We linked birth certificates, hospital discharge abstracts (including interhospital transfers), and fetal and… 

The Effect of Neonatal Intensive Care Level and Hospital Volume on Mortality of Very Low Birth Weight Infants

Although deregionalization of perinatal services may increase access to care for high-risk mothers and newborns, its impact on hospital volume may outweigh its potential benefit.

Effects of a Birth Hospital's Neonatal Intensive Care Unit Level and Annual Volume of Very Low-Birth-Weight Infant Deliveries on Morbidity and Mortality.

The annual volume of deliveries was the stronger contributor to the risk of death, death or severe intraventricular hemorrhage, and death or necrotizing enterocolitis and was lowest among infants born in hospitals that had both a high volume of VLBW infant deliveries and a high-level NICU.

Hospital volume and mortality of very low-birthweight infants in South America.

Increasing the access of pregnancies at-risk of VLBW and VPB to medium- or high-volume hospitals up to 144 V LBW infants per year may substantially improve in-hospital infant survival in the study countries.

Risk-adjusted mortality of VLBW infants in high-volume versus low-volume NICUs

Depending on the severity of the disease, the risk-adjusted mortality in German NICUs with 50 or less annual cases of VLBW infants may be significantly increased.

The impact of neonatal care resources on regional variation in neonatal mortality among very low birthweight infants in Korea.

BACKGROUND Faced with extremely low fertility rates and increasing numbers of low-birthweight births in Korea, we examined the factors affecting the mortality of very-low-birthweight (VLBW) infants

Obstetrical volume and early neonatal mortality in preterm infants

This study has shown a slight, but non-significant association between obstetrical volume and early neonatal mortality, and the impact of caseload on outcome may become more evident when referring to high-risk patients instead of to the overall number of deliveries.

Association Between Hospital Recognition for Nursing Excellence and Outcomes of Very Low-BirthWeight Infants

ONE IN 4 VERY LOW-BIRTHweight (VLBW) infants ( 1500 g) dies in the first year of life; nearly all deaths (87%) occur in the first month. Infant mortality in the United States is concentrated in this

Association Between Neonatal Intensive Care Unit Type and Quality of Care in Moderate and Late Preterm Infants.

In this cohort study, composite quality scores were lower for MLP infants in type C NICUs, whereas extremely and very preterm compositequality scores were similar across NICU types.

5-year morbidity among very preterm infants in relation to level of hospital care.

The increased incidence of retinopathy and asthma among infants transferred from level III to lower-level hospitals calls for analysis of the differences in treatment practices between hospital levels.



Newborn intensive care and neonatal mortality in low-birth-weight infants: a population study.

It is inferred that birth at a Level 3 center lowers neonatal mortality in low-birth-weight infants, however, only 34 per cent of the patients in this study were born in such units.

Mortality in low birth weight infants according to level of neonatal care at hospital of birth.

The results support the recommendation that hospitals with no NICU or intermediate NICUs transfer high-risk mothers with estimated fetal weight of <2000 g to a regional NICU and the evidence for the few hospitals with large community NICUs is mixed.

Mortality in very preterm and very low birth weight infants according to place of birth and level of care: results of a national collaborative survey of preterm and very low birth weight infants in The Netherlands.

Although the uncorrected mortality rates were similar, the mortality odds were significantly higher in level 1 and level 2 hospitals compared with level 3 hospitals, and the overall mortality rate is expected to decrease further.

Effect of Opening Midlevel Neonatal Intensive Care Units on the Location of Low Birth Weight Births in California

The introduction of new midlevel units was associated with significant shifts of births from both high-level and low-level hospitals to midlevel hospitals, and the majority of the increase in midlevel deliveries was attributable to shifts from high- level unit births.

Trends in mortality and morbidity for very low birth weight infants, 1991-1999.

Major changes in both obstetric and neonatal care during the 1990s were associated with decreases in mortality and morbidity for VLBW infants during the first half of the decade, but since 1995, no additional improvements in mortality or morbidity have been seen, ending a decades-long trend of improving outcomes for these infants.

The effects of patient volume and level of care at the hospital of birth on neonatal mortality.

Concentration of high-risk deliveries in urban areas in a smaller number of hospitals that could provide level III NICU care has the potential to decrease neonatal mortality without increasing costs.

The relation between the availability of neonatal intensive care and neonatal mortality.

A minority of regions in the United States may have inadequate neonatal intensive care resources, whereas many others may have more resources than are needed to prevent the death of high-risk newborns.

Age at death used to assess the effect of interhospital transfer of newborns.

Overall neonatal death rates were separately examined at each of the three levels of care for singleton live-births weighing 501 to 2,250 g in New York City, and mortality relative to level 3 improved for level 1 births, but worsened for level 2 births.

The choice of place of delivery. Effect of hospital level on mortality in all singleton births in New York City.

In an analysis of all singleton births and neonatal deaths with known birth weights and gestational ages in New York City maternity services during a three-year period (1976 to 1978), intensive care

Perinatal mortality: the role of hospital of birth.

  • R. Kirby
  • Medicine
    Journal of perinatology : official journal of the California Perinatal Association
  • 1996
Although Arkansas's NNMR compares favorably with the national average, further reductions would be likely were a formal system of perinatal regionalization implemented in this state.