MORBIDITY AND MORTALITY OF INFANTS BORN BEFORE ARRIVAL AT THE HOSPITAL

Recently, a number of infants have been born at home, in an ambulance, car, etc., before arrival at the District of Columbia General Hospita l. Many of these infants had poor outcome. To evaluate the prevalence and outcome of these infants, we reviewed medical records of all infan ts born before arrival at the hospital (out-born infants) and compared them with in-hospital deliveries from July 1988 to June 1992. Data we re analyzed using Fisher's Exact Test and chi-square test. There were 151 (1.8%) out-born infants and 8,169 (98.2%) in-born infants during t his 4-year period. Infants in both groups were predominantly black (85 %). The following were significant differences (P<0.001) between out-b orn and in-hospital deliveries, respectively: illicit drug exposure 35 % vs 21%; low-birth-weight (<2,500 g) infants 39% vs 16%; intensive ca re unit admissions 29% vs 15%; and neonatal deaths per 1,000 live birt hs 80 vs 7. We conclude that there is a twofold increase in the morbid ity (required intensive care) and an 11-fold increase in the mortality among out-born infants compared with infants delivered in-hospital. E ven though out-born infants were <2% of the total deliveries, they acc ounted for 17% of total neonatal mortality.