The association between hospital obstetric volume and perinatal outcomes in California - 21/11/12
Résumé |
Objective |
We sought to analyze the association between hospital obstetric volume and perinatal outcomes in California.
Study Design |
This was a retrospective cohort study of births occurring in California in 2006. Hospitals were divided into 4 obstetric volume categories. Unadjusted rates of neonatal mortality and birth asphyxia were calculated for each category, overall and among term deliveries with birthweight >2500 g. Multivariable logistic regression was used to control for confounders. Deliveries in rural hospitals were analyzed separately using different volume categories.
Results |
Prevalence of asphyxia increased with decreasing hospital volume overall and among term, non-low-birthweight infants, from 9/10,000 live births at highest-volume hospitals to 18/10,000 live births at the lowest-volume hospitals (P < .001). Similar trends were observed in rural hospitals, with rates increasing from 7-34/10,000 live births in low-volume rural hospitals (P < .001).
Conclusion |
These findings provide evidence for an inverse association between hospital obstetric volume and birth asphyxia.
Le texte complet de cet article est disponible en PDF.Key words : asphyxia, health care systems, health facility size, neonatal mortality
Plan
| Y.W.C. is supported by the University of California, San Francisco Women's Reproductive Health Research Career Development Award, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health (K12 HD001262). |
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| The authors report no conflict of interest. |
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| Reprints not available from the authors. |
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| Cite this article as: Snowden JM, Cheng YW, Kontgis C, et al. The association between hospital obstetric volume and perinatal outcomes in California. Am J Obstet Gynecol 2012;207:478.e1-7. |
Vol 207 - N° 6
P. 478.e1-478.e7 - décembre 2012 Retour au numéro
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