Evidence map›Paper›PMID 39304118›Full record

Observational studyThe Journal of pediatrics2025

The Impact of Hospital Delivery Volumes of Newborns Born Very Preterm on Mortality and Morbidity.

Ciaran S Phibbs, Molly Passarella, Susan K Schmitt, Ashley Martin, Scott A Lorch

Abstract readObservational Study
In one paragraph

Observational study in The Journal of pediatrics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Birth certificate data substantially misrepresent actual NICU admissions, including among most vulnerable.Journal of perinatology : official journal of the California Perinatal Association · 2026
    Article
  2. Disparities in delivery hospital risk-adjusted outcomes for very low birthweight infants: the role of NICU volume and level of care.Journal of perinatology : official journal of the California Perinatal Association · 2026
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Ciaran S PhibbsHealth Economics Resource Center and Center for Implementation to Innovation, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA; Department of Pediatrics, Stanford University School of Medicine, Stanford, CA; Department of Health Policy, Stanford University School of Medicine, Stanford, CA. Electronic address: cphibbs@stanford.edu.
Molly PassarellaDepartment of Pediatrics, University of Pennsylvania, Philadelphia, PA; Center for Outcomes Research, The Children's Hospital of Philadelphia, Philadelphia, PA.
Susan K SchmittHealth Economics Resource Center and Center for Implementation to Innovation, Veterans Affairs Palo Alto Health Care System, Menlo Park, CA; Department of Pediatrics, Stanford University School of Medicine, Stanford, CA.
Ashley MartinDepartment of Pediatrics, University of Pennsylvania, Philadelphia, PA; Center for Outcomes Research, The Children's Hospital of Philadelphia, Philadelphia, PA.
Scott A LorchDepartment of Pediatrics, University of Pennsylvania, Philadelphia, PA; Center for Outcomes Research, The Children's Hospital of Philadelphia, Philadelphia, PA; Leonard Davis Institute of Health Economics, Wharton School, University of Pennsylvania, Philadelphia, PA.

Funding

Effect of Changing NICU Patient Volumes and Levels of Care on Neonatal OutcomesR01HD084819 · NICHD · STANFORD UNIVERSITY · PI LORCH, SCOTT A, PHIBBS, CIARAN S. · 2016 to 2018
$1.1M
REGIONALIZATION, MARKET FORCES, AND NEONATAL MORTALITYR01HD036914 · NICHD · PALO ALTO INSTITUTE FOR RES &EDU, INC. · PI PHIBBS, CIARAN S · 2000 to 2003
$952k
NICHD NIH HHS R01 HD036914NICHD NIH HHS R01 HD084819
6 · The paper itself

Abstract

objectiveTo examine if the annual patient volume of infants born very preterm (VPT, gestational age <32 weeks) at a hospital is associated with neonatal mortality and morbidity. STUDY

designWe performed an observational, secondary data analysis using a 20-year panel of birth certificates linked to hospital discharge abstracts, including transfers in California, Michigan, Missouri, Oregon, Pennsylvania, and South Carolina from 1996 through 2015. The study included all in-hospital VPT deliveries (n = 208 261). Study outcomes were in-hospital mortality or serious morbidity (intraventricular hemorrhage, necrotizing enterocolitis, retinopathy of prematurity, or bronchopulmonary dysplasia), attributed to the hospital of birth. Poisson regression models estimated the risk-adjusted relative risk (RR) for mortality and serious morbidity across different patient volume categories within a given hospital using hospital fixed effects.

resultsThe risk of mortality and serious morbidity for VPT infants increased as the number of infants born VPT at a hospital decreased. Compared with VPT delivery volumes >100 infants per year, the risk of mortality increased when a given hospital had VPT delivery volumes < 60 per year, ranging from a RR of 1.13 (95% C.I. 1.02-1.25) for volumes between 50 to 59 and 1.39 (1.19-1.62) for VPT volumes <10, and the risk of mortality or serious morbidity increased when a given hospital had VPT volumes <100, ranging from a RR of 1.05 (1.02-1.08) for volumes between 90 to 99 and 1.27 (1.19-1.36) for VPT volumes <10.

conclusionsThese results suggest that, for VPT infants, the risk of both mortality and mortality or serious morbidity is increased as the VPT volume within a given hospital declines.

Indexed as

Hospital MortalityInfant MortalityInfant, Premature, DiseasesDelivery, ObstetricFemaleGestational AgeHumansInfantInfant, Extremely PrematureInfant, NewbornMaleMorbidityUnited States

Identifiers

PMID39304118
PMCPMC11645198

What OpenQuestion holds

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Registered trials

None linked

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.