Hospital Factors Associated with the Survival of Infants Born at Periviable Gestation: The USA National Database

Reports on the survival of infants born at periviable gestation (GA of ≤24 weeks and birth weight of <500 gm) vary significantly. We aimed to determine hospital factors associated with their survival and to assess the trend for the timing of postnatal mortality in these periviable infants. We uti...

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Published inChildren (Basel) Vol. 11; no. 1; p. 133
Main Authors Qattea, Ibrahim, Quatei, Amani, Farghaly, Mohsen A A, Abdalla, Alshimaa, Mohamed, Mohamed A, Aly, Hany
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 01.01.2024
Subjects
Births
Datasets
Health aspects
Infants
Medical care
Medical care, Cost of
Mortality
Neonatal care
NICU
Pediatrics
perinatal epidemiology
periviable gestation
Pregnancy
Premature babies
preterm
Quality management
survival
Teaching hospitals
Trends
Serbia
United States > US
preterm
NICU
perinatal epidemiology
periviable gestation
survival
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Summary:Reports on the survival of infants born at periviable gestation (GA of ≤24 weeks and birth weight of <500 gm) vary significantly. We aimed to determine hospital factors associated with their survival and to assess the trend for the timing of postnatal mortality in these periviable infants. We utilized the de-identified National Inpatient Sample (NIS) dataset of the Healthcare Cost and Utilization Project (HCUP) from the Agency for Healthcare Research and Quality (AHRQ). National data were analyzed for the years 2010-2018. Hospitals were categorized according to delivery volume, USA regions, and teaching status. We identified 33,998,014 infants born during the study period; 76,231 infants were ≤24 weeks. Survival at birth and first 2 days of life was greatest in urban teaching hospitals in infants <24 weeks and those who completed 24 weeks, respectively. The Northeast region has the lowest survival rate. There was a significant delay in the postnatal day of mortality in periviable infants. Hospital factors are associated with increased survival rates. Improved survival in large teaching hospitals supports the need for the regionalization of care in infants born at the limits of viability. There was a significant delay in the postnatal mortality day.
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ISSN:2227-9067
2227-9067
DOI:10.3390/children11010133