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Relationship of Hospital Staff Coverage and Delivery Room Resuscitation Practices to Birth Asphyxia.

CPQCC Publication
TitleRelationship of Hospital Staff Coverage and Delivery Room Resuscitation Practices to Birth Asphyxia.
Publication TypeJournal Article
Year of Publication2017
AuthorsTu JH, Profit J, Melsop K, Brown T, Davis A, Main E, Lee HC
JournalAm J Perinatol
Date Published2017 Feb
KeywordsAnesthesiology, Asphyxia Neonatorum, California, Checklist, Delivery Rooms, Hospitals, High-Volume, Hospitals, Maternity, Hospitals, Rural, Hospitals, Urban, Humans, Infant, Newborn, Medical Staff, Hospital, Neonatology, Obstetrics, Pediatrics, Resuscitation, Specialization, Surveys and Questionnaires, Workforce

 The objective of this study was to assess utilization of specialist coverage and checklists in perinatal settings and to examine utilization by birth asphyxia rates.  This is a survey study of California maternity hospitals concerning checklist use to prepare for delivery room resuscitation and 24-hour in-house specialist coverage (pediatrician/neonatologist, obstetrician, and obstetric anesthesiologist) and results linked to hospital birth asphyxia rates (preterm and low weight births were excluded).  Of 253 maternity hospitals, 138 responded (55%); 59 (43%) indicated checklist use, and in-house specialist coverage ranged from 38% (pediatrician/neonatologist) to 54% (anesthesiology). In-house coverage was more common in urban versus rural hospitals for all specialties ( < 0.0001), but checklist use was not significantly different ( = 0.88). Higher birth volume hospitals had more specialist coverage ( < 0.0001), whereas checklist use did not differ ( = 0.3). In-house obstetric coverage was associated with lower asphyxia rates (odds ratio: 0.34; 95% confidence interval [CI]: 0.20, 0.58) in a regression model accounting for other providers. Checklist use was not associated with birth asphyxia (odds ratio: 1.12; 95% CI: 0.75, 1.68).  Higher birth volume and urban hospitals demonstrated greater in-house specialist coverage, but checklist use was similar across all hospitals. Current data suggest that in-house obstetric coverage has greater impact on asphyxia than other specialist coverage or checklist use.

Alternate JournalAm J Perinatol
PubMed ID27487231