Affiliations: Kadlec Regional Medical Center, Richland, WA,
USA | University of Washington School of Medicine,
Department of Pediatrics, Seattle, WA, USA | Seattle Children's Hospital, Seattle, WA, USA
Note: [] Corresponding author: Anthony Hadeed, MD, FAAP, 800 Swift Blvd,
Suite 330, Richland, WA 99352, USA. Tel.: +1 509 942 2615; Fax: +1 509 946
4762; E-mail: ajhbabydoc@aol.com
Abstract: Objective: To evaluate the changes in outcome that occurred during
implementation of a comprehensive outreach program to five level I newborn care
facilities, by one level III neonatal intensive care unit in rural WA State. Study design: Standardized outreach educational programs were provided.
Outcome measures were assessed by collecting monthly perinatal and postnatal
data on 61,551 births. Three six-year periods were defined. Period I
(1988–1994) was compared with period II (1994–2000) and period III
(2000–2006). Results: Comparing the averages for the three periods,
there was a statistically significant increase in maternal transports from
level I hospitals, and significant decreases in early-onset sepsis, meconium
aspiration syndrome, low Apgar scores, major congenital malformations, neonatal
and perinatal mortality rates, very low birth weight (VLBW) infant mortality,
chronic lung disease and duration of hospital stay (all p< 0.001). Conclusion: A successful regionalization of perinatal service in rural areas
can be accomplished by establishing extensive outreach programs. This model can
be utilized to improve perinatal, neonatal and VLBW infant outcomes.
