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Objective <p>We hypothesized that outborn neonates in three rural states would have more frequent adverse short-term outcomes following therapeutic hypothermia (TH).</p> Study Design <p>Multicenter retrospective study comparing outcomes for low (&lt;500 births/year), medium (501–1500 births/year), and high (&gt;1500 births/year) birth volume hospitals in Northern New England. Multivariable logistic regression assessed the combined outcome of death/severe gray matter injury on MRI, controlling for encephalopathy severity and time to initiation of TH.</p> Results <p>Death occurred for 35/531 neonates: 15/120 (12%) low, 7/193 (4%) medium, and 13/218 (6%) for high birth volume hospitals (<i>p</i> = 0.008). Severe gray matter injury occurred in 8%, 6% and 7% of low, medium, and high birth volume hospitals, respectively (<i>p</i> = 0.7). Odds of the combined outcome were 4.3-fold higher in low versus high volume hospitals (95% CI = 1.6, 12.1, <i>p</i> = 0.004).</p> Conclusion <p>Neonates born in low volume birth hospitals had significantly higher odds of death following treatment with TH.</p>

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Association of low hospital birth volume and adverse short-term outcomes for neonates treated with therapeutic hypothermia in rural states

  • 期刊论文

  • 发表日期：

    2025年7月6日

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  • Alexa K. Craig,
  • Anya Cutler,
  • Jay Kerecman,
  • Misty Melendi,
  • Leah Marie Seften,
  • Matthew Ryzewski,
  • Allison Zanno,
  • Deirdre O’Reilly

摘要

Objective

We hypothesized that outborn neonates in three rural states would have more frequent adverse short-term outcomes following therapeutic hypothermia (TH).

Study Design

Multicenter retrospective study comparing outcomes for low (<500 births/year), medium (501–1500 births/year), and high (>1500 births/year) birth volume hospitals in Northern New England. Multivariable logistic regression assessed the combined outcome of death/severe gray matter injury on MRI, controlling for encephalopathy severity and time to initiation of TH.

Results

Death occurred for 35/531 neonates: 15/120 (12%) low, 7/193 (4%) medium, and 13/218 (6%) for high birth volume hospitals (p = 0.008). Severe gray matter injury occurred in 8%, 6% and 7% of low, medium, and high birth volume hospitals, respectively (p = 0.7). Odds of the combined outcome were 4.3-fold higher in low versus high volume hospitals (95% CI = 1.6, 12.1, p = 0.004).

Conclusion

Neonates born in low volume birth hospitals had significantly higher odds of death following treatment with TH.