Level 2 hospital delivery of low birth weight infants 1970-1979.

We have reviewed the outcome for low birth weight infants in a designated Level 2 hospital. In New York City, hospitals are classified as Level 1, Level 2 and Level 3; the latter being the large tertiary center. St. Luke's-Roosevelt Hospital Center, Roosevelt Division is a Level 2 institution modified by components of Level 3 expertise. The data presented spans 10 years comparing results before (Level 2) and after (Level 2+) upgrading of services. The survival of very low birth weight infants improved as a result of the change and is comparable to the tertiary center. The factors are discussed. It is concluded that an institution can decide on the lowest gestational age and/or birth weight to be managed within its perinatal service.