Opportunities for maternal transport for delivery of very low birth weight infants

OBJECTIVE: To assess frequency of very low birth weight (VLBW) births at non-Level III hospitals. STUDY DESIGN: Retrospective cohort study using linked California birth certificate and discharge data 2008–2010 for deliveries of singleton or first-born infant of multiple gestations with birth weight 400–1500g. Delivery rates by neonatal level of care were obtained. Risk of delivery at non-level III centers was estimated in univariable and multivariable models. RESULTS: Of 1,508,143 births, 13,919 (9.2%) were VLBW; birth rate at non-Level III centers was 14.9% (8.4% in Level I, and 6.5% in Level II). Median rate of VLBW births was 0.3% (range 0%–4.7%) annually at Level I and 0.5% (range 0%–1.6%) at Level II hospitals. Antepartum stay >24 hours occurred in 14.0% and 26.9% of VLBW births in Level I and Level II hospitals, respectively. CONCLUSION: Further improvement is possible in reducing VLBW infant delivery at suboptimal sites, given the window of opportunity for many patients.