Association of Low Hospital Birth Volume and Adverse Short-Term Outcomes for Neonates Treated with Therapeutic Hypothermia in Rural States
2024

Impact of Hospital Birth Volume on Neonate Outcomes After Hypothermia

Sample size: 531 publication Evidence: moderate

Author Information

Author(s): Craig Alexa, Cutler Anya, Kerecman Jay, Melendi Misty, Seften Leah Marie, Ryzewski Matthew, Zanno Allison, Barkhuff Whittney, O'Reilly Deirdre

Hypothesis

Outborn neonates from smaller birth volume hospitals would have more frequent adverse short-term outcomes following therapeutic hypothermia.

Conclusion

Neonates born in small volume hospitals had significantly higher odds of death or severe gray matter injury following therapeutic hypothermia.

Supporting Evidence

  • 531 neonates were included from small, medium, and large volume hospitals.
  • The odds of the combined outcome were 4.3-fold higher in small versus large birth volume hospitals.
  • TH was initiated at a median of 4.5, 4, and 2 hours of life respectively for small, medium, and large hospitals.

Takeaway

Babies born in smaller hospitals are more likely to have serious problems after treatment than those born in larger hospitals.

Methodology

Multicenter retrospective study comparing outcomes for small, medium, and large hospitals using multivariable logistic regression.

Participant Demographics

Included neonates from small (<500 births/year), medium (501-1500 births/year), and large (>1500 births/year) hospitals.

Statistical Information

P-Value

0.004

Confidence Interval

95% CI = 1.6, 12.1

Statistical Significance

p=0.004

Digital Object Identifier (DOI)

10.21203/rs.3.rs-5404622

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