The survival of very low-birth weight infants by level of hospital of birth: A population study of perinatal systems in four states

Gortmaker, Steven L.; Sobol, Arthur M.; Clark, Colleen J. G.; Walker, Deborah Klein; Geronimus, Arline T.

doi:10.1016/0002-9378(85)90618-0

Cited by 107 publications

(35 citation statements)

References 10 publications

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“…A variação da taxa de mortalidade que existe entre diferentes serviços neonatais constitui tema muito discutido na literatura 2,3,4,9,12,14 . Atualmente sabe-se que esta diferença não pode ser interpretada apenas como conseqüência da qualidade da assistência médica prestada.…”

Section: Introductionunclassified

Valor preditivo do "Clinical Risk Index for Babies" para o risco de mortalidade neonatal

et al. 1998

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Section: Introductionunclassified

Valor preditivo do "Clinical Risk Index for Babies" para o risco de mortalidade neonatal

et al. 1998

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“…Most investigators have noted a twofold improvement in outcome for infants under 2500 gm when born in a high technology facility (Level III) compared to birth in a low technology facility (Level 1). [3][4][5][6][7] A close correlate ofhigh technology is volume, since a high volume of patients is required to justify the expense of purchase, maintenance, and staffing of high technology. This high volume is also thought to lead to improved skill in the use ofthe technology.…”

Section: Introductionmentioning

confidence: 99%

The relation of obstetrical volume and nursery level to perinatal mortality.

Mayfield¹,

Rosenblatt²,

Baldwin³

et al. 1990

Am J Public Health

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“…Despite variations in hospital facilities and heterogeneity of the population, studies over the years in various parts of the world [2,3,4] have shown higher mortality rates of very premature infants born outside tertiary facilities compared with those born in tertiary centers, commonly known as outborn and inborn infants. Improved outcomes from regionalization have been demonstrated in population-based and cohort studies of high-risk preterm infants [4,5,6] and reaffirmed by a meta-analysis of more than 30 years [7] of data. …”

Section: Introductionmentioning

confidence: 99%

Outborns or Inborns: Where Are the Differences? A Comparison Study of Very Preterm Neonatal Intensive Care Unit Infants Cared for in Australia and New Zealand and in Canada

Hossain

Shah²,

Ye³

et al. 2015

Neonatology

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Background: Very preterm infants born outside tertiary centers are at higher risks of adverse outcomes than inborn infants. Regionalization of perinatal care has been introduced worldwide to improve outcomes. Objective: To compare the risk-adjusted outcomes of both inborn and outborn infants cared for in tertiary neonatal intensive care units in Australia and New Zealand and in Canada. Methods: Deidentified data of infants <32 weeks' gestational age from the 29 Australian and New Zealand Neonatal Network units (ANZNN; n = 9,893) and 26 Canadian Neonatal Network units (CNN; n = 7,133) between 2005 and 2007 were analyzed for predischarge adverse outcomes. Results: ANZNN had lower rates of outborns compared to CNN (13 vs. 19%), particularly of late admissions (>2 days of age; 5.8 vs. 22.2% of outborns) who had high morbidity rates. After adjusting for confounding variables including gestation, ANZNN inborn infants had lower odds of chronic lung disease [CLD; 17.0 vs. 23.3%; adjusted odds ratio (AOR) = 0.70, 95% CI: 0.64-0.77], severe neurological injuries on ultrasound (SNI; 4.1 vs. 6.7%; AOR = 0.62, 95% CI: 0.53-0.73), severe retinopathy (5.6 vs. 7%; AOR = 0.71, 95% CI: 0.59-0.84) and necrotizing enterocolitis (3.5 vs. 5.4%; AOR = 0.67, 95% CI: 0.56-0.79), but no difference in mortality odds. After excluding the late outborn admissions, ANZNN outborns had lower odds of SNI (AOR = 0.43, 95% CI: 0.32-0.58) and CLD (AOR = 0.63, 95% CI: 0.49-0.81) than CNN. Conclusions: ANZNN inborn and early admitted outborn infants had lower odds of neonatal morbidities than their CNN counterparts. However, compared to ANZNN, the higher CNN rates of outborns and their late admissions are likely related to the differences in regionalization and referral practices, and may explain differences in outcomes.

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The survival of very low-birth weight infants by level of hospital of birth: A population study of perinatal systems in four states

Cited by 107 publications

References 10 publications

Valor preditivo do "Clinical Risk Index for Babies" para o risco de mortalidade neonatal

Valor preditivo do "Clinical Risk Index for Babies" para o risco de mortalidade neonatal

The relation of obstetrical volume and nursery level to perinatal mortality.

Outborns or Inborns: Where Are the Differences? A Comparison Study of Very Preterm Neonatal Intensive Care Unit Infants Cared for in Australia and New Zealand and in Canada

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