title: The relation of obstetrical volume and nursery level to perinatal mortality.
abstract: We investigated the relation of hospital delivery volume and nursery technology level to perinatal outcome in 226,164 White singleton births in Washington State, 1980-83. Level III facilities (neonatal intensive care unit) were defined by the state licensing commission. We defined the Level II (intermediate) and Level I (normal newborn) facilities using published criteria. Infants under 2000 gm born in Level III facilities had half the risk of perinatal death compared to those born in a Level I or II facility. No significant improvement was noted among level or volume groupings for normal birthweight infants. A loglinear regression model of hospital perinatal death rates showed that when birthweight and maternal risk were controlled, obstetrical volume added minimal explanatory power to level of nursery care.
authors.affiliation: Department of Family Medicine, Health Services and Biostatistics, University of Washington, Seattle.
authors.forename: J A
authors.initials: JA
authors.lastname: Mayfield
authors.forename: R A
authors.initials: RA
authors.lastname: Rosenblatt
authors.forename: L M
authors.initials: LM
authors.lastname: Baldwin
authors.forename: J
authors.initials: J
authors.lastname: Chu
authors.forename: J P
authors.initials: JP
authors.lastname: Logerfo
mesh_terms: D001724:Birth Weight; D003627:Data Interpretation, Statistical; D036861:Delivery, Obstetric; D005260:Female; D005313:Fetal Death / Q000453:epidemiology*; D006764:Hospitals, Community / Q000706:statistics & numerical data*; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data; D009725:Nurseries, Hospital / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D012044:Regression Analysis; D012307:Risk Factors; D014861:Washington / Q000453:epidemiology