Recent changes in delivery site of low-birth-weight infants in Washington : impact on birth weight-specific mortality.
Our purpose was to ascertain whether the proportion of low-birth-weight infants delivered in Washington at tertiary hospitals changed between 1980 and 1991 and whether mortality differed by level of birth hospital.
A retrospective cohort study was performed of 500 to 2499 gm infants born to Washington residents between 1980 and 1991 (n=43,228).
Overall, the percentage of low-birth-weight infants born at tertiary centers rose from 1980 to 1982 through 1986 to 1988 and subsequently declined significantly.
Among infants weighing<2000 gm nontertiary delivery was associated with greater potentially preventable mortality (500 to 999 gm, relative risk 1.5,95% confidence interval 1.3 to 1.8 ; 1000 to 1499 gm, relative risk 2.1,95% confidence interval 1.3 to 3.3 ; 1500 to 1999 gm, relative risk 1.6,95% confidence interval 1.0 to 2.6).
Nontertiary delivery of 2000 to 2499 gm infants was associated with lower overall mortality (relative risk 0.5,95% confidence interval 0.3 to 0.8), but higher-risk deliveries in this birth weight range were apparently concentrated at tertiary hospitals.
In light of the apparent benefit of tertiary center birth for infants weighing<2000 gm, the possible erosion of effective regionalized perinatal care networks should be monitored closely.
Mots-clés Pascal : Poids naissance faible, Nouveau né, Homme, Prématuré, Mortalité, Epidémiologie, Hôpital, Unité soin intensif, Réanimation, Etats Unis, Amérique du Nord, Amérique
Mots-clés Pascal anglais : Low birth weight, Newborn, Human, Premature, Mortality, Epidemiology, Hospital, Intensive care unit, Resuscitation, United States, North America, America
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0041924
Code Inist : 002B20G01. Création : 01/03/1996.