May 25, 2007 (Insidermedicine) Premature babies are more likely to survive if they are born at hospitals with high level neonatal care units that treat a high volume of patients, according to research published in the New England Journal of Medicine.

More and more community hospitals are being outfitted with a neonatal intensive care unit - or NICU - to care for very-low-birth-weight infants. The result is that the volume of infants treated at high-performing centers, that offer the high level expertise necessary to care for these challenging patients, is decreasing. Infants treated in the NICU tend to have complications during or after birth, and some require surgery or treatment for infections.

To study the differences in survival rates among various NICUs, data of more than 48,000 very-low-birth-weight infants was assessed. The study included various levels of care, including the provision of mechanical ventilation, life support and neonatal surgery, including open-heart surgery and cardiopulmonary bypass.

It was found that the death rate among infants varied according to the volume of patients and the level of care provided by the hospital. In hospitals that treated more than 100 very-low-birth-weight infants annually, the death rate was the lowest. However, only 36% of premature infants were born in high-level facilities in 1991, and fewer than one-quarter in 2000. It is estimated that 21% of the deaths of these infants may have been prevented if they had been born in a hospital specializing in treating high-risk low birth weight infants.

It is suggested that merging smaller existing NICUs would create larger, more specialized centers capable of dealing better with the demands of treating high-risk infants.

Reporting for Insidermedicine, I’m Maria Radina.