Mayfield J A, Rosenblatt R A, Baldwin L M, Chu J, Logerfo J P
Department of Family Medicine, Health Services and Biostatistics, University of Washington, Seattle.
Am J Public Health. 1990 Jul;80(7):819-23. doi: 10.2105/ajph.80.7.819.
We investigated the relation of hospital delivery volume and nursery technology level to perinatal outcome in 226,164 White singleton births in Washington State, 1980-83. Level III facilities (neonatal intensive care unit) were defined by the state licensing commission. We defined the Level II (intermediate) and Level I (normal newborn) facilities using published criteria. Infants under 2000 gm born in Level III facilities had half the risk of perinatal death compared to those born in a Level I or II facility. No significant improvement was noted among level or volume groupings for normal birthweight infants. A loglinear regression model of hospital perinatal death rates showed that when birthweight and maternal risk were controlled, obstetrical volume added minimal explanatory power to level of nursery care.
我们调查了1980 - 1983年期间华盛顿州226,164例白人单胎分娩中，医院分娩量和新生儿护理技术水平与围产期结局的关系。三级设施（新生儿重症监护病房）由州许可委员会定义。我们使用已发表的标准定义了二级（中级）和一级（正常新生儿）设施。与在一级或二级设施出生的婴儿相比，在三级设施出生的体重不足2000克的婴儿围产期死亡风险减半。对于正常出生体重的婴儿，在级别或数量分组中未发现显著改善。医院围产期死亡率的对数线性回归模型显示，在控制出生体重和产妇风险后，产科分娩量对新生儿护理水平的解释力微乎其微。
