Modifiable Hospital Factors Associated With Survival of Infants Born at Periviable Gestation: the US National Database

Abstract Objective:To determine modifiable hospital factors associated with survival of infants with GA ≤24 weeks and birth weight <500gm in the USA. And to assess the trend for the timing of postnatal mortality in these periviable infants.Design: National data were analyzed for the years 2010-2018. Hospitals were categorized according to delivery volume, US regions, and teaching status.Results: We identified 33,998,014 infants born during the study period; 76,231 infants were ≤24 weeks. Survival was greatest in urban teaching hospitals in infants <24 weeks and completed 24 weeks, respectively. The Northeast region has the lowest survival rate. There was a significant delay in the postnatal day of mortality in periviable infants.Conclusions: Hospital factors are associated with increased survival rates. Improved survival in large teaching hospitals supports the need for regionalization of care in infants born at the limits of viability. There was a significant delay in the postnatal mortality day.