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Am J Perinatol 2014; 31(08): 659-666
DOI: 10.1055/s-0033-1356484
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Influence of Neonatal Practice Variation on Outcomes of Late Preterm Birth

Sofia Aliaga
1   Department of Pediatrics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
,
Kim Boggess
2   Department of Obstetrics and Gynecology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
,
Thomas S. Ivester
2   Department of Obstetrics and Gynecology, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
,
Wayne A. Price
1   Department of Pediatrics, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
› Author Affiliations
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Publication History

08 July 2013

05 August 2013

Publication Date:
10 September 2013 (online)

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Abstract

Objective Examine variation in short-term outcomes of late preterm births (340/7–366/7 weeks) between a university teaching hospital, teaching community hospital, and nonteaching community hospital.

Study Design Review of maternal and newborn data from a random sample of late preterm births at three hospitals in North Carolina from 2008 to 2009. Outcomes included length of stay, neonatal intensive care unit (NICU) admission, respiratory support, antibiotic exposure, phototherapy exposure, and hypoglycemia.

Results We analyzed data from 331 singleton late preterm newborns: 93 (28.1%) from a university teaching hospital, 110 (33.2%) from a teaching community hospital, and 128 (38.7%) from a nonteaching community hospital. Mean gestational age did not vary between hospitals. NICU admission, exposure to antibiotics, and phototherapy were more common at the university teaching hospital after controlling for risk factors, yet length of stay was shortest at the university teaching hospital and longest at the teaching community hospital after adjustment.

Conclusion Practice variation contributes to differences in length of stay, NICU admission, and exposure to antibiotics and phototherapy among late preterm newborns. Differences in practice during the birth hospitalization may affect outcomes and health care utilization (e.g., readmission) after discharge.

Keywords

late preterm - practice variation - neonatal care

Comment to this article:

Dr. Sofia Aliaga InterviewAm J Perinatol 2014; 31(08): e1-e1
DOI: 10.1055/s-0034-1383899

 

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