Influence of neonatal practice variation on outcomes of late preterm birth

Am J Perinatol. 2014 Sep;31(8):659-66. doi: 10.1055/s-0033-1356484. Epub 2013 Sep 10.


Objective: Examine variation in short-term outcomes of late preterm births (34(0/7)-36(6/7) weeks) between a university teaching hospital, teaching community hospital, and nonteaching community hospital.

Study design: Review of maternal and newborn data from a random sample of late preterm births at three hospitals in North Carolina from 2008 to 2009. Outcomes included length of stay, neonatal intensive care unit (NICU) admission, respiratory support, antibiotic exposure, phototherapy exposure, and hypoglycemia.

Results: We analyzed data from 331 singleton late preterm newborns: 93 (28.1%) from a university teaching hospital, 110 (33.2%) from a teaching community hospital, and 128 (38.7%) from a nonteaching community hospital. Mean gestational age did not vary between hospitals. NICU admission, exposure to antibiotics, and phototherapy were more common at the university teaching hospital after controlling for risk factors, yet length of stay was shortest at the university teaching hospital and longest at the teaching community hospital after adjustment.

Conclusion: Practice variation contributes to differences in length of stay, NICU admission, and exposure to antibiotics and phototherapy among late preterm newborns. Differences in practice during the birth hospitalization may affect outcomes and health care utilization (e.g., readmission) after discharge.

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Cohort Studies
  • Female
  • Gestational Age
  • Hospitalization / statistics & numerical data
  • Hospitals, Community / statistics & numerical data*
  • Hospitals, Teaching / statistics & numerical data*
  • Hospitals, University / statistics & numerical data*
  • Humans
  • Infant Care / statistics & numerical data*
  • Infant, Newborn
  • Infant, Premature
  • Intensive Care Units, Neonatal / statistics & numerical data
  • Length of Stay / statistics & numerical data
  • Male
  • Phototherapy / statistics & numerical data
  • Postnatal Care / statistics & numerical data*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Premature Birth*
  • Prospective Studies


  • Anti-Bacterial Agents