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Am J Perinatol 2017; 34(03): 259-263
DOI: 10.1055/s-0036-1586505
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Relationship of Hospital Staff Coverage and Delivery Room Resuscitation Practices to Birth Asphyxia

Joanna H. Tu
1   College of Physicians and Surgeons, Columbia University, New York, New York
,
Jochen Profit
2   Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Stanford, California
,
Kathryn Melsop
3   California Maternal Quality Care Collaborative, Stanford, California
,
Taylor Brown
2   Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Stanford, California
,
Alexis Davis
2   Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Stanford, California
,
Elliot Main
3   California Maternal Quality Care Collaborative, Stanford, California
,
Henry C. Lee
2   Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University, Stanford, California
› Author Affiliations
Further Information

Publication History

01 March 2016

21 June 2016

Publication Date:
03 August 2016 (online)

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Abstract

Objective The objective of this study was to assess utilization of specialist coverage and checklists in perinatal settings and to examine utilization by birth asphyxia rates.

Design This is a survey study of California maternity hospitals concerning checklist use to prepare for delivery room resuscitation and 24-hour in-house specialist coverage (pediatrician/neonatologist, obstetrician, and obstetric anesthesiologist) and results linked to hospital birth asphyxia rates (preterm and low weight births were excluded).

Results Of 253 maternity hospitals, 138 responded (55%); 59 (43%) indicated checklist use, and in-house specialist coverage ranged from 38% (pediatrician/neonatologist) to 54% (anesthesiology). In-house coverage was more common in urban versus rural hospitals for all specialties (p < 0.0001), but checklist use was not significantly different (p = 0.88). Higher birth volume hospitals had more specialist coverage (p < 0.0001), whereas checklist use did not differ (p = 0.3). In-house obstetric coverage was associated with lower asphyxia rates (odds ratio: 0.34; 95% confidence interval [CI]: 0.20, 0.58) in a regression model accounting for other providers. Checklist use was not associated with birth asphyxia (odds ratio: 1.12; 95% CI: 0.75, 1.68).

Conclusion Higher birth volume and urban hospitals demonstrated greater in-house specialist coverage, but checklist use was similar across all hospitals. Current data suggest that in-house obstetric coverage has greater impact on asphyxia than other specialist coverage or checklist use.

Keywords

checklists - neonatal resuscitation - specialist coverage - birth asphyxia - safety

Note

The authors have no conflict of interest to disclose. The funders (NICHD) had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the article; and decision to submit the article for publication. This study was approved by the Institutional Review Board of Stanford University. The authors thank Lisa Bollman of the Regional Perinatal Programs of California for assistance in obtaining data across California maternity hospitals.