Relation between size of delivery unit and neonatal death in low risk deliveries: population based study
a Department of
Paediatrics, Haukeland University Hospital, N-5021 Bergen, Norway, b Division
for Medical Statistics, University of Bergen, Haukeland Hospital, c Medical Birth
Registry of Norway
Correspondence to: Dr Dag Moster. Email: Dag.Moster{at}smis.uib.no
Accepted 13 November
1998
AIM
To examine risk of
neonatal death after low risk pregnancies in relation to size of
delivery units.
METHODSA population
based study of live born singleton infants in Norway with birthweights
of at least 2500 g was carried out. Antenatal risk factors were
adjusted for.
RESULTSFrom 1972 to
1995, 1.25 million births fulfilled the criteria. The neonatal death
rate was lowest for maternity units with 2001-3000 annual births and
steadily increased with decreasing size of the maternity unit to around
twice that for units with less than 100 births a year (odds ratio 2.1;
95 % confidence interval 1.6 to 2.8). Institutions with more than 3000 deliveries a year also had a higher rate (odds ratio 1.7; 95% CI 1.4 to 2.0), but analyses suggest that this rate is overestimated.
CONCLUSIONAround
2000 to 3000 annual births are needed to reduce the risk of neonatal
deaths after low risk deliveries.
Keywords: maternity unit size; low risk delivery; neonatal mortality
© 1999 by Archives of Disease in Childhood
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