Kirby R S
Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock 72205, USA.
J Perinatol. 1996 Jan-Feb;16(1):43-9.
Patterns of perinatal mortality in a state with no organized system or guidelines for regionalized perinatal health care were examined.
Vital statistics on live births, fetal deaths, and neonatal deaths in Arkansas for 1985 through 1989 were analyzed by birth hospital level of obstetric care, birth weight, and county of residence. Birth weight-specific fetal and neonatal mortality rates (NNMR) were compared by level of obstetric care at the birth facility; multivariate logistic regression models estimated the odds of NNMR by level of obstetric hospital, adjusted for other risk factors.
Infants of < 2000 gm birth weight tend to have lower NNMR when born at level III hospitals than when born at level II facilities. The proportion of very low birth weight (< 1500 gm) and moderately low birth weight (1500 to 2499 gm) infants delivered at level III hospitals in Arkansas is lower than that in other states with formal systems of perinatal regionalization.
Although Arkansas's NNMR compares favorably with the national average, further reductions would be likely were a formal system of perinatal regionalization implemented in this state.
对一个没有系统化的围产期保健区域化体系或指南的州的围产期死亡率模式进行研究。
对1985年至1989年阿肯色州活产、死胎和新生儿死亡的生命统计数据，按照产科护理的分娩医院级别、出生体重和居住县进行分析。按分娩机构的产科护理级别比较特定出生体重的胎儿和新生儿死亡率（NNMR）；多变量逻辑回归模型估计产科医院级别导致NNMR的几率，并对其他风险因素进行调整。
出生体重<2000克的婴儿在三级医院出生时的NNMR往往低于在二级机构出生时的NNMR。阿肯色州三级医院分娩的极低出生体重（<1500克）和中度低出生体重（1500至2499克）婴儿的比例低于其他有围产期区域化正式体系的州。
尽管阿肯色州的NNMR与全国平均水平相比情况较好，但如果该州实施围产期区域化正式体系，可能会进一步降低。
