About Careers Internship MedBlog Contact us
Medindia LOGIN REGISTER
Advertisement

Higher Death Rate Observed for Very Low-birth-weight Infants Born at Less-specialized Hospitals

by Kathy Jones on September 2, 2010 at 9:12 PM
 Higher Death Rate Observed for Very Low-birth-weight Infants Born at Less-specialized Hospitals

Very low-birth-weight and very preterm infants not born in highly specialized, level III hospitals have an associated higher likelihood of neonatal and predischarge death compared to similar infants born at level III hospitals, according to an article in the September 1 issue of JAMA.

"For more than 30 years, guidelines for perinatal [pertaining to the period immediately before and after birth] regionalization have recommended that very low-birth-weight (VLBW) infants be born at highly specialized hospitals, most commonly designated as level III hospitals. Despite these recommendations, some regions continue to have large percentages of VLBW infants born in lower-level hospitals," according to background information in the article.

Advertisement

Sarah Marie Lasswell, M.P.H., of the Centers for Disease Control and Prevention, Atlanta, and colleagues conducted a meta-analysis of previous research to examine the relationship between hospital level at birth and neonatal (generally the first four weeks after birth) or predischarge mortality for VLBW (1,500 grams [53 ounces] or less) and very preterm (VPT; 32 weeks or less gestation) infants to determine the importance of level of care at birth to survival. The researchers identified 41 publications that met criteria to be included in the study.

Analysis of the data of the VLBW studies (n = 37; 104,944 infants) indicated a 62 percent increase in odds of neonatal/predischarge death for infants born in non-level III hospitals compared with those born in level III hospitals (38 percent vs. 23 percent). When restricted to only higher-quality evidence (9 publications; 46,318 infants), a 60 percent increase in the odds of neonatal and/or predischarge mortality was estimated for VLBW infants born at non-level III hospitals (36 percent vs. 21 percent). Also, extremely low-birth-weight infants (1,000 grams [35 ounces] or less) born in non-level III hospitals had an estimated 80 percent increase in odds of neonatal and/or predischarge mortality compared with those born at level III hospitals (59 percent vs. 32 percent).
Advertisement

The weighted, combined data from 4 publications regarding VPT infants (n = 9,300) indicated that VPT infants born in lower-level hospitals have a 55 percent increase in odds of neonatal/predischarge mortality compared with those born in level III facilities (15 percent vs. 17 percent). Restricting to the 3 studies rated as adequate- and high-quality (n = 6,100 infants) reduced the estimate to a 42 percent increased odds of death (7 percent vs. 12 percent).

"The results of this review confirm a primary premise on which perinatal regionalization systems are based: high-risk infants have higher mortality rates when born outside hospitals with the most specialized levels of care. Although they represent less than 2 percent of U.S. births, 55 percent of infant deaths occur among VLBW infants. Strengthening perinatal regionalization systems in states with high percentages of VLBW and VPT infants born outside of level III centers could potentially save thousands of infant lives every year," the authors write.

"Future research should use appropriate risk adjustment and thorough reporting of hospital-level information. Further exploration of the effect of hospital volume, obstetrical level, infants that remain for care at lower-level hospitals after birth, and additional outcome measures such as long-term infant morbidity and fetal and maternal mortality will add to the understanding of this important intervention."



Source: Eurekalert
Font : A-A+

Advertisement

Advertisement
Advertisement

Recommended Readings

Latest Child Health News

Do Adverse Drug Reactions Cause Autism Spectrum Disorder?
Side-effects of valproate drug taken during pregnancy, enhance the expression of Rnf146 gene, causing autism spectrum disorder in fetus.
Amblyopia or Poor Vision in Kids - Does Digital Vision Training Help?
Children with amblyopia or lazy eye who underwent digital vision training, showed no appreciable improvement in their eyesight.
Childhood Malnutrition Linked to Stunted Growth and Mortality Risk
In 2022, over 20% of children worldwide lacked adequate calories for growth, with 45+ million showing wasting (underweight for height).
Pneumococcal Vaccines Reduce Severe Infections in Kids With Sickle Cell Disease
After PCV7 licensure, pneumococcal infection rates in children aged 5+ with sickle cell disease significantly decreased.
Breast Milk Proteins to Boost Baby's Gut Health
Breast milk concentration of certain key proteins indicates abundance of healthy bacteria in babies' guts.
View All
This site uses cookies to deliver our services.By using our site, you acknowledge that you have read and understand our Cookie Policy, Privacy Policy, and our Terms of Use  Ok, Got it. Close
MediBotMediBot
Greetings! How can I assist you?MediBot
×

Higher Death Rate Observed for Very Low-birth-weight Infants Born at Less-specialized Hospitals Personalised Printable Document (PDF)

Please complete this form and we'll send you a personalised information that is requested

You may use this for your own reference or forward it to your friends.

Please use the information prudently. If you are not a medical doctor please remember to consult your healthcare provider as this information is not a substitute for professional advice.

Name *

Email Address *

Country *

Areas of Interests