Editorial

摘要

The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists have guidelines for perinatal care in which they recommend that hospital-based services be organized within geographic regions to provide optimal access to expertise and experience. According to these guidelines, very-low-birth-weight (VLBW; <1500 grams) should be delivered at subspecialty perinatal centers, defined by their ability to provide. comprehensive care for pregnant women and neonates of all-risk categories. Studies have shown that VLBW infants bom at nonsubspecialty centers have a 1.5 to 2.8 times increased risk of death when compared with VLBW infants bom at specialty centers. Additional studies comparing outcomes of VLBW infants who were outbom to those inborn at subspecialty centers found similar results. Although regionalization is the goal, VLBW, premature, or distressed term infants continue to need immediate transport to or from a neonatal intensive care unit for further definitive diagnosis and treatment.