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  • Annual volume of very low-birth-weight infant deliveries appears to be more important than level of neonatal intensive care unit for optimising perinatal care

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Prognosis
Cohort study
Annual volume of very low-birth-weight infant deliveries appears to be more important than level of neonatal intensive care unit for optimising perinatal care
  1. Sorina Grisaru-Granovsky1,
  2. Lital Keinan-Boker2
  1. 1Department of Obstetrics and Gynecology, Shaare Zedek MC, affiliated to the Hebrew University of Jerusalem, Jerusalem, Israel;
  2. 2Israel Center for Disease Control, Israel Ministry of Health, Jerusalem, Israel
  1. Correspondence to: Professor Sorina Grisaru-Granovsky, Department of Obstetrics and Gynecology, Head of Division of Maternal Fetal Medicine, Shaare Zedek MC, 12 Bayt Blv, Jerusalem 91031, Israel; Sorina{at}szmc.org.il

https://doi.org/10.1136/ebmed-2015-110293

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    Commentary on: Jensen EA, Lorch SA. 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. JAMA Pediatr 2015;169:e151906.

    Context

    The goal of perinatal care regionalisation is to improve the likelihood that new borns requiring sophisticated support are born in appropriately equipped centres. The present study evaluates associations between birth hospital characteristics, and neonatal morbidity and morbidity–mortality composites, and assesses the strength of these associations by concurrent analyses of birth hospitals’ annual very low-birth-weight (VLBW) infant deliveries, neonatal intensive care unit (NICU) level and neonatal outcomes.

    Methods

    The study included birth weights (BW) of 500–1499 g. It excluded BWs of >5SDs from mean for gestational age, infants <500 g and those with severe congenital anomalies.

    The three US states chosen have non-homogeneous demographics—a potentially destabilising variable not considered in the models. Primary outcomes were composites of death or bronchopulmonary dysplasia (BPD), …

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    Footnotes

    • Competing interests None declared.

    • Provenance and peer review Commissioned; internally peer reviewed.