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Strengthening the evidence for maternal and child health programs

Find Established Evidence

Displaying records 1 through 6 (6 total).

Nugent RR. Perinatal regionalization in North Carolina, 1967-1979: services, programs, referral patterns, and perinatal mortality rate declines for very low birthweight infants. N C Med J. 1982;43(7):513-515.

Link: https://www.ncbi.nlm.nih.gov/pubmed/6956811

NPM: 3: Perinatal Regionalization
Intervention Components (click on component to see a list of all articles that use that intervention): HOSPITAL, Development/Improvement of Services, Continuing Education of Hospital Providers, Needs Assessment, POPULATION-BASED SYSTEMS, STATE, Policy/Guideline (State), Funding Support, Perinatal Committees/Councils, Increased Reimbursement

Intervention Results:

Among all VLBW infants, there was a change in birth location distribution. Of these infants, the percentage born in level III hospitals increased from 25.7% in period one to 46.8% in period four. The percentage born in level II hospitals decreased from 41.7% to 36% and the percentage born in level I also decreased from 32.6% to 17.2%. The authors do not comment on the statistical significance of these results.

Bowes WA, Jr. A review of perinatal mortality in Colorado, 1971 to 1978, and its relationship to the regionalization of perinatal services. Am J Obstet Gynecol. 1981;141(8):1045-1052.

Link: https://www.ncbi.nlm.nih.gov/pubmed/7315916

NPM: 3: Perinatal Regionalization
Intervention Components (click on component to see a list of all articles that use that intervention): HOSPITAL, Continuing Education of Hospital Providers, POPULATION-BASED SYSTEMS, STATE, Policy/Guideline (State), Funding Support, Perinatal Committees/Councils

Intervention Results:

The proportion of VLBW births among total births in each hospital level shifted between the pretest and posttest period. In level III hospitals, the proportion of VLBW births among total births rose from 2.8% to 4.8% (p<0.05). In level II hospitals, the proportion of VLBW births among total births stayed the same (1.9%). In level I hospitals, there was a decrease from 1.6% to 1.1% of total births.

Campbell MK, Chance GW, Natale R, Dodman N, Halinda E, Turner L. Is perinatal care in southwestern Ontario regionalized? CMAJ. 1991;144(3):305-312.

Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1452689/

NPM: 3: Perinatal Regionalization
Intervention Components (click on component to see a list of all articles that use that intervention): HOSPITAL, Continuing Education of Hospital Providers, POPULATION-BASED SYSTEMS, INTER-HOSPITAL SYSTEMS, Maternal/In-Utero Transport Systems, Follow-Up Given On Transferred Patients, STATE, Perinatal Committees/Councils, NICU Bed Registry/Electronic Bulletin Board

Intervention Results:

  • Among all women admitted to level I or II hospitals, the percentage of maternal transfer to level III hospitals increased from 2.2% of all admitted women (262 women) to 2.8% (p<0.003) after the intervention.
  • Among all women admitted to level I or II hospitals, maternal transfer of those with labor or threatened preterm labor before 37 weeks gestation to level III hospitals increased by 38% from 0.72% of all admitted women to 0.99% after intervention (p=0.024).
  • Among all infants born at 500-1499 gm, there was a statistically significant change in distribution of the number born in level III hospitals after intervention (p<0.001)

Hein HA. Evaluation of a rural perinatal care system. J Pediatr. 1980;66(4):540-546.

Link: http://pediatrics.aappublications.org/content/66/4/540

NPM: 3: Perinatal Regionalization
Intervention Components (click on component to see a list of all articles that use that intervention): HOSPITAL, Development/Improvement of Services, Continuing Education of Hospital Providers, Needs Assessment, POPULATION-BASED SYSTEMS, INTER-HOSPITAL SYSTEMS, Maternal/In-Utero Transport Systems, Agreement for Level III Hospital to Accept All Patients, Perinatal Committees/Councils, STATE

Intervention Results:

  • The intervention in Iowa focused on increasing both level III and level II VLBW births due to population density concerns in Iowa.
  • Among all VLBW infants, there were changes in the birth location distribution. Of these infants, there was a statistically significant increase in percentage born in level III hospitals from 6.7% to 22.6% (p<0.05)1 and an increase in births in level II hospitals from 26.9% to 35.6%. The percentage born in level I centers decreased from 68.2% to 41.8%.

Hein HA, & Burmeister LF. The effect of ten years of regionalized perinatal health care in Iowa, U.S.A. Eur J Obstet Gynecol Reprod Biol. 1986;21(1):33-48.

Link: https://www.ncbi.nlm.nih.gov/pubmed/3956827

NPM: 3: Perinatal Regionalization
Intervention Components (click on component to see a list of all articles that use that intervention): HOSPITAL, Development/Improvement of Services, Continuing Education of Hospital Providers, Needs Assessment, POPULATION-BASED SYSTEMS, INTER-HOSPITAL SYSTEMS, Maternal/In-Utero Transport Systems, Agreement for Level III Hospital to Accept All Patients, STATE, Funding Support, Perinatal Committees/Councils

Intervention Results:

  • The intervention in Iowa focused on increasing both level III and level II VLBW births due to population density concerns in Iowa.
  • Among all VLBW infants, there was a statistically significant change in the distribution of VLBW births (p<0.001). Of these infants, there was an increase in percentage born in level III hospitals from 6.7% to 35.3% and an increase in level II hospitals from 30.6% to 42.9%. The percentage born in level I centers decreased from 62.7% to 21.8%.

Lui K, Abdel-Latif ME, Allgood CL, et al. Improved outcomes of extremely premature outborn infants: effects of strategic changes in perinatal and retrieval services. J Pediatr. 2006; 2006 Nov; 118(5):2076-2083.

Link: https://www.ncbi.nlm.nih.gov/pubmed/17079581

NPM: 3: Perinatal Regionalization
Intervention Components (click on component to see a list of all articles that use that intervention): Maternal/In-Utero Transport Systems, INTER-HOSPITAL SYSTEMS, POPULATION-BASED SYSTEMS, Consultation Systems, Perinatal Committees/Councils, NICU Bed Registry/Electronic Bulletin Board

Intervention Results:

  • Among all infants born at 23 to 28 weeks GA, there was a statistically significant decrease in the percentage of non-tertiary hospital births from 30.1% to 24.6% (p<0.001).
    • This decrease was mostly driven by a large decrease among births at 23 to 24 weeks GA from 50.8% to 37.6% (p<0.001).
    • The decrease among all births at 25 to 26 and 27 to 28 weeks was not statistically significant (p= 0.075 and p= 0.194, respectively)
   

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.