This study will focus on the assessment of the impact of the available level of technological support at the hospital of delivery on survival of premature deliveries and their health status at age 3. The American Hospital Association (AHA) maintains data on technological and staffing levels of hospitals. This data, from the AHA records of 1988, will be linked to each Longitudinal Follow-up (LF) delivery record (birth or fetal death) for which a hospital was identified by a maternal respondent on the 1988 National Maternal & Infant Health Survey (NMIHS). In addition, information from NMIHS respondents with live births resulting in deaths identified prior to the 1991 LF will be added to the data files. Survival analysis probability models will be used to predict outcomes associated with level of technological support available and/or used at the time of delivery and immediately thereafter. The data will be stratified by gestational age at delivery to account for differences in developmental status (which may affect the probability of any subsequent infant deaths), the use of interventions and the level of technological support available at the delivery hospital. Adjustments for confounding by appropriate variables, e.g., use of maternal transport at the time of delivery, and/or transport of the infant immediately following delivery, will be assessed in each sub-analysis. The health status at age three will also be compared for extremely premature and normal gestation infants. It is anticipated that the analysis of the aforementioned data will better define the effects of availability of technological support at the time of delivery.
| Schwartz, R M; Muri, J H; Overpeck, M D et al. (2000) Use of high-technology care among women with high-risk pregnancies in the United States. Matern Child Health J 4:18-Jul |
