The association between hospital obstetric volume and perinatal outcomes in California

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

doi:10.1016/j.ajog.2012.09.029

The association between hospital obstetric volume and perinatal outcomes in California

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

Obstetrics and Gynecology

Research output: Contribution to journal › Article › peer-review

47 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 language	English (US)
Pages (from-to)	478.e1-478.e7
Journal	American journal of obstetrics and gynecology
Volume	207
Issue number	6
DOIs	https://doi.org/10.1016/j.ajog.2012.09.029
State	Published - Dec 2012

Keywords

asphyxia
health care systems
health facility size
neonatal mortality

ASJC Scopus subject areas

Obstetrics and Gynecology

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10.1016/j.ajog.2012.09.029

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title = "The association between hospital obstetric volume and perinatal outcomes in California",

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.",

keywords = "asphyxia, health care systems, health facility size, neonatal mortality",

author = "Snowden, {Jonathan M.} and Cheng, {Yvonne W.} and Kontgis, {Caitlin P.} and Caughey, {Aaron B.}",

note = "Funding Information: 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 ). ",

year = "2012",

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doi = "10.1016/j.ajog.2012.09.029",

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AU - Kontgis, Caitlin P.

AU - Caughey, Aaron B.

N1 - Funding Information: 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 ).

PY - 2012/12

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N2 - 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.

AB - 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.

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KW - health facility size

KW - neonatal mortality

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The association between hospital obstetric volume and perinatal outcomes in California

Abstract

Keywords

ASJC Scopus subject areas

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