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(Ivanhoe Newswire) -- Babies who tip the scales at less than 3.3 pounds at birth are better off if they're born at larger hospitals with more sophisticated neonatal intensive care units (NICUs).
That's the key finding from California researchers who compared birth records and death certificates for 48,000 very-low-birth-weight infants born in the state between 1991 and 2000. Babies born at community hospitals with lower level NICUs were up to about three-times more likely to die than those born at bigger hospitals with high level NICUs that cared for 100 or more such infants each year.
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The investigators don't believe smaller community hospitals are necessarily doing a bad job of caring for these infants but do believe larger hospitals with high level NICUs offer more resources that make the difference in survival.
The authors write, "Mortality among very-low-birth-weight infants was lowest for deliveries that occurred in hospitals with NICUs that had both a high level of care and a high volume of such patients. Our results suggest that increased use of such facilities might reduce mortality among very-low-birth-weight infants."
Since 92 percent of the births in their study occurred in urban areas where high-level NICUs were available, the researchers believe it would be possible to regionalize high risk deliveries to these locations, at least in California. Such a move, they continue, could prevent 21 percent of the deaths seen among these tiny infants.
This article was reported by Ivanhoe.com, which offers Medical Alerts by e-mail every day of the week. To subscribe, click on: http://www.ivanhoe.com/newsalert/.
SOURCE: The New England Journal of Medicine, 2007;356:2165-2175
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