Related Experiment Video
Updated: Aug 18, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Perinatal regionalization and neonatal mortality in North Carolina, 1968-1994
M M Bode1, T M O'shea, K R Metzguer
1Department of Pediatrics, University of North Carolina, Chapel Hill, USA.
Objective:
Our purpose was to analyze trends across time in the regionalization of low-birth-weight births and time trends for the association between regionalization and decreased neonatal mortality.
Study Design:
Data on 69,452 neonates with birth weights of 500 to 2000 g were obtained from electronic files of birth certificates. Hospitals' perinatal services were classified as level 1, 2, or 3 (level 3 refers to tertiary referral centers).
Results:
The likelihood of birth outside level 3 hospitals decreased from 1968 to 1994, with an average annual decrease of 24% for infants weighing 500 to 1500 g and 20% for infants weighing 1501 to 2000 g. After 1974, birth in a hospital with level 3 services was associated with a lower risk of dying. The strength of this association increased in the 1990s.
Conclusions:
In North Carolina the proportion of infants weighing <2000 g born outside a hospital with level 3 neonatal services declined from 1974 through 1994. After 1974, birth in a hospital with level 3 neonatal services was associated with lower neonatal mortality.
