2003

Birth Hospital Type Affects Outcome For Very Low Birth Weight Infants

Monday, December 22, 2003

CINCINNATI -- A new Cincinnati Children's Hospital Medical Center study demonstrates that very low birth weight infants have a markedly better outcome if they are born at hospitals that specialize in providing care for high-risk babies.

The study, published in the January issue of Pediatrics, shows that very low birth weight infants born at hospitals that do not specialize in high-level perinatal or neonatal care face twice the risk of death or serious illness as infants of the same weight who are born in hospitals with high-level, subspecialty care.

"The study supports existing recommendations that infants born at less than 32 weeks gestation be delivered at hospitals that are able to provide comprehensive care for pregnant women and neonates in all risk categories," according to Barb Warner, MD, a neonatologist at Cincinnati Children's and TriHealth Hospitals and the study's lead author.

Dr. Warner, along with colleagues at the Child Policy Research Center at Cincinnati Children's, studied very low birth weight infants born at 19 hospitals in the Cincinnati area between September 1, 1995, and December 31, 1997. These infants weighed between 500 and 1499 grams -- approximately 1.1 to 3.3 pounds. Outcome was measured by death or illness, including such complications of prematurity as bronchopulmonary dysplasia, a serious lung disease; severe intracranial hemorrhage, a bleeding in the brain; and severe retinopathy of prematurity, a disease of the eye's retina.

"Very low birth weight infants represent roughly 1.3 percent of live births, yet these infants account for 60 percent of neonatal deaths and perhaps a larger share of life-long handicapping conditions that arise from perinatal events," says Dr. Warner. "The outcome for these children is better at specialty centers. It is important to note that these results pertain to very premature infants and not to the majority of larger infants, where delivery at non-subspecialty centers is both safe and appropriate."

The American Academy of Pediatrics and American College of Obstetricians and Gynecologists guidelines for perinatal care recommend that hospital-based services be organized within geographic regions, as they are in the Cincinnati area, to provide optimal access to expertise and experience.