Opportunities for maternal transport for delivery of very low birth weight infants

Objective:to assess frequency of very low birth weight (vlbw) births at non-level iii hospitals.study design:retrospective cohort study using linked california birth certificate and discharge data of 2008 to 2010 for deliveries of singleton or first-born infant of multiple gestations with birth weight 400 to 1500 g. delivery rates by neonatal level of care were obtained. risk of delivery at non-level iii centers was estimated in univariable and multivariable models.results:of the 1 508 143 births, 13 919 (9.2%) were vlbw; birth rate at non-level iii centers was 14.9% (8.4% in level i and 6.5% in level ii). median rate of vlbw births was 0.3% (range 0 to 4.7%) annually at level i and 0.5% (range 0 to 1.6%) at level ii hospitals. antepartum stay for >24 h occurred in 14.0% and 26.9% of vlbw births in level i and level ii hospitals, respectively.conclusion:further improvement is possible in reducing vlbw infant delivery at suboptimal sites, given the window of opportunity for many patients.