The association between hospital obstetric volume and perinatal outcomes in California

Jonathan M. Snowden, Yvonne W. Cheng, Caitlin P. Kontgis, Aaron B. Caughey

Research output: Contribution to journalArticle

32 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)478.e1-478.e7
JournalAmerican journal of obstetrics and gynecology
Volume207
Issue number6
DOIs
StatePublished - Dec 2012

Keywords

  • asphyxia
  • health care systems
  • health facility size
  • neonatal mortality

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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