A study was performed to determine differences in mortality rates of infants in selected Level II and Level III centers. Birthweight specific mortality rates were determined using linked birth and death certificate records of infants born within the Seattle Metropolitan area.. During the five year study period, 1988-1992, 2,707 infants weighing less than 2,500 g (LBW) were born in six selected level II hospitals and 4,139 LBW infants were born at two level III centers. The level II nurseries had neonatologists available 24 hours per day and were capable of providing neonatal intensive care including invasive arterial monitoring, CPAP, and parenteral nutrition. Infants requiring mechanical ventilation, surgery, or cardiac evaluation were transferred to a Level III facility. During the five year study period infants greater than 32 weeks were routinely delivered in the selected Level II hospitals. Infants between 30 and 32 weeks gestation were delivered after consulation between neonatologist, obstetrician and family. Maternal transport to a level III hospital was indicated for all pregnancies of less than 30 weeks gestation. Infants less than 30 weeks gestation were delivered in the level II hospitals only when fetal status or the course of labor precluded maternal transport. Deaths due to [Illegible Text] 18 and anencephaly were excluded from the analysis. Infant mortality rates are presented in thetable below.

Table 1
Full size table

These data support the delivery of infants with birthweights greater than 1000 g at selected Level II hospitals.