The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #59961

Kim Y. Wells, CHES, Carol Lau, Zipora Weinbaum, PhD, and Ellen J. Stein, MD, MPH. Maternal and Child Health Branch, California Department of Health Services, 714 P Street, Room 476, Sacramento, CA 95814, (916) 654-5448, kwells@dhs.ca.gov

BACKGROUND: A Healthy People 2010 (HP2010) objective is to increase to 90% the proportion of very low birth weight (VLBW) infants (<1,500 grams) born in facilities with the technology necessary to deliver and care for high-risk infants. This study examines California’s progress towards this goal and compares four race/ethnic groups. METHODS: California’s 2001 birth records were used to identify VLBW infants and their birth settings. Births were dichotomized into: 1) “appropriate” (“Regional” or “Community” hospital), and 2) “other” (“Intermediate” or non- Children Services hospital, or out of the hospital) and stratified by maternal race/ethnicity. Proportions and confidence intervals were calculated and Chi-square analysis performed. RESULTS: Of the 528,609 infants born in California hospitals in 2001, 1.1% were VLBW infants (n=6066). Overall 62.6% of VLBW infants were delivered in appropriate facilities (n=76) with 67.2% (95% confidence interval (CI), 64.1%-70.2%) of non-Hispanic Black, 62.9% (95% CI, 61.1%-64.7%) of Hispanic, 61.9% (95% CI, 59.6%-64.1%) of non-Hispanic White, and 56.6% (95% CI, 52.6%-60.6%) of Asian VLBW birth occurring in appropriate facilities (p<0.0013). Race/ethnic groups differ statistically in mean birth weight and insurance. Further analyses will explore this association with appropriate facilities. CONCLUSION: Overall, the proportion of VLBW infants born in appropriate facilities is below the HP2010 objective. Asian VLBW infants are less likely than non-Hispanic Black and Hispanic to be born in appropriate facilities. Further targeting of all race/ethnic groups, particularly Asians is needed to identify and mitigate barriers to delivering VLBW infants in appropriate facilities.

Learning Objectives:

• Define the term "appropriate facility" 2)Describe differences by race/ethnicity of very low birth weight births in appropriate facilities 3)Identify populations at risk for very low birth weight births occurring in inappropriate facilities 4)Evaluate California's progress towards the HP2010 obstetrical objective for very low birth weight infants born in appropriate facilities

Keywords: Healthy People 2000/2010, Birth Outcomes

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.