ArticleObstetrics and gynecology2020
Regional and Racial-Ethnic Differences in Perinatal Interventions Among Periviable Births.
Article in Obstetrics and gynecology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Survival outcomes among periviable infants: a systematic review and meta-analysis comparing different income countries and time periods.Frontiers in public health · 2024Pooled it
- From "can we treat?" to "should we treat?": a narrative review on resuscitation limits at the threshold of viability.European journal of pediatrics · 2026Review
- Social Vulnerability and Pregnancy Option Counseling in the Setting of Periviable Delivery.Journal of clinical medicine · 2025Article
- [Analysis of treatment outcomes of extremely preterm infants in a real-world single center].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2024Article
- At the threshold of viability: to resuscitate or not to resuscitate - the perspectives of Israeli neonatologists.BMJ paediatrics open · 2024Article
- Neonatal Intensive Care Unit Resource Use for Infants at 22 Weeks' Gestation in the US, 2008-2021.JAMA network open · 2024Article
- Association of Active Postnatal Care With Infant Survival Among Periviable Infants in the US.JAMA network open · 2023Article
- Active Treatment of Infants Born at 22-25 Weeks of Gestation in California, 2011-2018.The Journal of pediatrics · 2022Observational
- Article
- Changes Overtime in Perinatal Management and Outcomes of Extremely Preterm Infants in One Tertiary Care Romanian Center.Medicina (Kaunas, Lithuania) · 2022Article
- Overview of Perinatal Practices with Potential Neurodevelopmental Impact for Children Affected by Preterm Birth.The Journal of pediatrics · 2022Article
- Changes in hospital quality at hospitals serving black and hispanic newborns below 30 weeks' gestation.Journal of perinatology : official journal of the California Perinatal Association · 2022Article
- Expecting equity: reimagining the delivery of racial/ethnic representation in neonatal clinical trials.Journal of perinatology : official journal of the California Perinatal Association · 2022Article
- An Immature Science: Intensive Care for Infants Born at ≤23 Weeks of Gestation.The Journal of pediatrics · 2021Review
- Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo examine whether there are: 1) regional differences in three perinatal interventions that reflect active treatment among periviable gestations and 2) racial-ethnic differences in the receipt of these perinatal interventions after accounting for hospital region.
methodsWe conducted a retrospective study on neonates born at 776 U.S. centers that participated in the Vermont Oxford Network (2006-2017) with a gestational age of 22-25 weeks. The primary outcome was postnatal life support. Secondary outcomes included maternal administration of antenatal corticosteroids and cesarean delivery. We examined rates and 99% CI of the three outcomes by region. We also calculated the adjusted relative risks (aRRs) and 99% CIs for the three outcomes by race and ethnicity within each region using modified Poisson regression models with robust variance estimation.
resultsMajor regional variation exists in the use of the three interventions at 22 and 23 weeks of gestation but not at 24 and 25 weeks. For example, at 22 weeks of gestation, rates of life support in the South (38.3%; 99% CI 36.3-40.2) and the Midwest (32.7%; 99% CI 30.4-35.0) were higher than in the Northeast (20.2%; 99% CI 17.6-22.8) and the West (22.2%; 99% CI 20.0-24.4). Particularly in the Northeast, black and Hispanic neonates born at 22 or 23 weeks of gestation had a higher provision of postnatal life support than white neonates (at 22 weeks: black: aRR 1.84 [99% CI 1.33-2.56], Hispanic: aRR 1.80 [1.23-2.64]; at 23 weeks: black: aRR 1.14 [99% CI 1.08-1.20], Hispanic: aRR 1.12 [1.05-1.19]). In the West, black and Hispanic neonates born at 23 weeks of gestation also had a higher provision of life support (black: aRR 1.11 [99% CI 1.03-1.19]; Hispanic: aRR 1.10 [1.04-1.16]).
conclusionMajor regional variation exists in perinatal interventions when managing 22- and 23-week neonates. In the Northeast and the West regions, minority neonates born at 22 and 23 weeks of gestation had higher provision of postnatal life support.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.