Location of birth and outcomes of extremely preterm infants

The EPICURE 2 study from the UK of babies born at 22 – 26 weeks gestation in 2006 found that only 56% of such infants were born in centers with level 3 NICUs. Ten percent were born in level 1 facilities. After risk-adjustment for gestation and birth-weight, babies who were born in level 3 NICUs had a lower rate of mortality than those born in level 2 NICUs, particularly with deaths around delivery (including fetal deaths) and during the first seven days of life. This higher survival was not associated with increased morbidity. Among level 3 units, mortality rates were lower in units that had higher levels of activity.

Perinatal outcomes for extremely preterm babies in relation to place of birth in England. Marlow et al, 2014.