Very low birth weight infants are significantly more likely to survive when delivered in hospitals with high-level neonatal intensive care units that care for more than 100 such newborns annually than are those delivered in comparable facilities that provide care to fewer than 100 such children every year.

The research that led to this finding was supported by the Agency for Healthcare Research and Quality and the National Institutes of Health, both agencies within the U.S. Department of Health and Human Services. Within NIH, support for the study was provided by the National Institute of Child Health and Human Development. The study appears in the May 24th issue of the New England Journal of Medicine.

Neonatal intensive care units (NICUs) are specialized hospital facilities offering medical care for newborn infants. NICUs are classified according to the level of services they provide. High-level neonatal intensive care units provide mechanical ventilationthe use of a device that assists with breathing. Depending on the level of care, some high-level NICUs provide major surgery.

Very low birth weight infants are those weighing less than 1500 grams, or about 3.3 pounds, at birth. Very low birth weight infants are highly vulnerable to medical complications. In 2000, these infants comprised just 1.4 percent of U.S. births but 51 percent of infant deaths. The latest research indicates some of these newborn deaths may be preventable.

Based on their analyses of California birth records, the researchers reported that less than a quarter of very low birth weight infants are born in hospitals with high-level, high-volume NICUs, and this percentage has been declining over time. The study examined differences in death rates across hospitals with different NICU levels and their volume (how many very low birth weight infants they care for in a year).

The researchers found that hospitals with lower-volume, lower-level
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Contact: Robert Bock
bockr@mail.nih.gov
301-496-5133
NIH/National Institute of Child Health and Human Development
23-May-2007