Gortmaker S, Sobol A, Clark C, Walker D K, Geronimus A
Am J Obstet Gynecol. 1985 Jul 1;152(5):517-24. doi: 10.1016/0002-9378(85)90618-0.
This study estimates differentials in survival among very low-birth weight infants according to hospital of birth, and seeks to determine importance of birth at high-technology centers versus birth at other urban or rural hospitals. Data from four states for 1978 and 1979 were used to estimate survival curves for the first 24 hours of life by type of hospital at birth, birth weight, and race. Significant (p less than 0.0001) differences in survival by type of hospital for both races at birth weights of 1000 to 1500 gm were observed. Smaller disparities were seen at birth weights of 750 to 1000 gm. Differentials in survival by hospital setting emerged in the first few hours after birth, underscoring the effectiveness of neonatal intensive care units in reducing infant mortality and the importance of maternal transport. Differentials persisted throughout the neonatal and postneonatal periods, although differences were attenuated. Prenatal assessment and provider and institutional cooperation can contribute to lowered mortality for high-risk infants and mothers.
本研究根据出生医院估计极低出生体重婴儿的生存差异，并试图确定在高科技中心出生与在其他城市或农村医院出生的重要性。利用1978年和1979年四个州的数据，按出生医院类型、出生体重和种族估计出生后头24小时的生存曲线。在出生体重为1000至1500克时，观察到两个种族在不同类型医院的生存存在显著差异（p小于0.0001）。在出生体重为750至1000克时，差异较小。出生后最初几个小时内出现了不同医院环境下的生存差异，这突出了新生儿重症监护病房在降低婴儿死亡率方面的有效性以及产妇转运的重要性。差异在整个新生儿期和新生儿后期持续存在，尽管差异有所减弱。产前评估以及医疗服务提供者和机构间的合作有助于降低高危婴儿和母亲的死亡率。
