Published online November 1, 2004
PEDIATRICS Vol. 114 No. 5 November 2004, pp. 1341-1347 (doi:10.1542/10.1542/peds.2004-1697)
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POLICY STATEMENT

Levels of Neonatal Care

Committee on Fetus and Newborn

The concept of designations for hospital facilities that care for newborn infants according to the level of complexity of care provided was first proposed in 1976. Subsequent diversity in the definitions and application of levels of care has complicated facility-based evaluation of clinical outcomes, resource allocation and utilization, and service delivery. We review data supporting the need for uniform nationally applicable definitions and the clinical basis for a proposed classification based on complexity of care. Facilities that provide hospital care for newborn infants should be classified on the basis of functional capabilities, and these facilities should be organized within a regionalized system of perinatal care.


Key Words: neonatal intensive care • high-risk infant • regionalization • health policy • very low birth weight infant • nurseries • hospital newborn care services

Abbreviations: NICU, neonatal intensive care unit • TIOP, Toward Improving the Outcome of Pregnancy • TIOP II, Toward Improving the Outcome of Pregnancy: The 90s and Beyond • VLBW, very low birth weight • OR, odds ratio • ECMO, extracorporeal membrane oxygenation



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