Opportunities for maternal transport for delivery of very low birth weight infants.
To assess frequency of very low birth weight (VLBW) births at non-level III hospitals.



Retrospective cohort study using linked California birth certificate and discharge data of 2008 to 2010 for deliveries of singleton or first-born infant of multiple gestations with birth weight 400 to 1500 g. Delivery rates by neonatal level of care were obtained. Risk of delivery at non-level III centers was estimated in univariable and multivariable models.



Of the 1 508 143 births, 13 919 (9.2%) were VLBW; birth rate at non-level III centers was 14.9% (8.4% in level I and 6.5% in level II). Median rate of VLBW births was 0.3% (range 0 to 4.7%) annually at level I and 0.5% (range 0 to 1.6%) at level II hospitals. Antepartum stay for >24 h occurred in 14.0% and 26.9% of VLBW births in level I and level II hospitals, respectively.



Further improvement is possible in reducing VLBW infant delivery at suboptimal sites, given the window of opportunity for many patients.
Department of Obstetrics and Gynecology, University of California, San Francisco, San Francisco, CA, USA.
D
D
Robles
Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA.|March of Dimes Prematurity Research Center, Stanford University, Stanford, CA, USA.
Y J
YJ
Blumenfeld
March of Dimes Prematurity Research Center, Stanford University, Stanford, CA, USA.|Department of Pediatrics, Stanford University, Stanford, CA, USA.|California Perinatal Quality Care Collaborative, Stanford, CA, USA.
H C
HC
Lee
March of Dimes Prematurity Research Center, Stanford University, Stanford, CA, USA.|Department of Pediatrics, Stanford University, Stanford, CA, USA.|California Perinatal Quality Care Collaborative, Stanford, CA, USA.
J B
JB
Gould
California Maternal Quality Care Collaborative, Stanford, CA, USA.|Sutter Pacific Medical Foundation, San Francisco, CA, USA.
E
E
Main
March of Dimes Prematurity Research Center, Stanford University, Stanford, CA, USA.|Department of Pediatrics, Stanford University, Stanford, CA, USA.|California Perinatal Quality Care Collaborative, Stanford, CA, USA.
J
J
Profit
California Maternal Quality Care Collaborative, Stanford, CA, USA.
K
K
Melsop
Department of Obstetrics and Gynecology, Stanford University, Stanford, CA, USA.|March of Dimes Prematurity Research Center, Stanford University, Stanford, CA, USA.
M
M
Druzin
D001723:Birth Rate; D002140:California / Q000453:epidemiology; D005260:Female; D006761:Hospitals / Q000145:classification* / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D018743:Perinatal Care / Q000191:economics; D011247:Pregnancy; D011272:Pregnancy, Multiple; D012189:Retrospective Studies; D014187:Transportation of Patients
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