Improved outcomes of outborn preterm infants if admitted to perinatal centers versus freestanding pediatric hospitals.

Abstract

To examine whether admission hospital type (13 perinatal centers vs 4 freestanding pediatric hospitals) was associated with differences in risk and illness severity adjusted mortality and morbidity among outborn preterm infants. Records of singleton outborn infants < or =32 weeks' gestational age (n = 605) admitted to 17 tertiary level neonatal intensive care units participating in the Canadian Neonatal Network for the period 1996 to 1997 were examined. Outborn infants admitted to freestanding pediatric hospitals were at higher risk of death (adjusted odds ratio [AOR], 2.25; 95% confidence interval [CI], 1.20, 4.20), nosocomial infection (AOR, 2.48; 95% CI, 1.64, 3.73), and oxygen dependency at 28 days of age (AOR, 1.77; 95% CI, 1.14, 2.75) when compared with outborn infants admitted to perinatal centers. After adjustment for perinatal risks and admission illness severity, outborn infants had better outcomes if they were admitted to perinatal centers compared with freestanding pediatric hospitals.