This study assessed the impact of mother's race, insurance status, and use of prenatal care on very low birthweight infant delivery in or transfer to hospitals with neonatal intensive care units (ICUs).
Multivariate analysis of Alabama vital statistics recods between 1988 to 1499 g was conducted, comparing hospital of birth and maternal and infant transfer status, and controlling for infant birthweight and for maternal pregnancy history and demographic characteristics.
With other factors adjusted for, non-White mothers with early prenatal care were more likely than White mothers to deliver their very low birthweight infants in hospitals with neonatal ICUs without transfer.
Among the mothers who presented first at hospitals without such facilities, those who had late prenatal were were less likely than those with early care to be transferred to hospitals with neonatal ICUs before delivery.
Medicaid coverage increased the likelihood of antenatal transfer for White women.
Likehood of infant transfer was not associated with these maternal characteristics.
Maternal race, prenatal care use, and insurance status may influence the likehood that very low birthweight infants will have access to neonatal intensive care.
Interventions to improve perinatal regionalization should address individual and system barriers to the timely referral of high-risk mothers.
Mots-clés Pascal : Accessibilité, Unité soin intensif, Néonatologie, Hôpital, Système santé, Nouveau né, Poids naissance faible, Epidémiologie, Mère, Assurance maladie, Race, Alabama, Homme, Etats Unis, Amérique du Nord, Amérique, Gestation pathologie, Prématurité, Nouveau né pathologie
Mots-clés Pascal anglais : Accessibility, Intensive care unit, Neonatology, Hospital, Health system, Newborn, Low birth weight, Epidemiology, Mother, Health insurance, Race, Alabama, Human, United States, North America, America, Pregnancy disorders, Prematurity, Newborn diseases
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0220404
Code Inist : 002B30A01B. Création : 09/06/1995.