Neonatal outcomes by hospital of birth in Nova Scotia between 1988 and 2012: improvements in mortality and morbidity
Bibliographic record
Abstract
Objectives: (1) To describe differences in newborn outcomes with respect to hospital of birth, place of maternal residence, and time epoch for infants born in Nova Scotia between 1988 and 2012. (2) To examine the possible impacts that regionalization of maternal newborn health services between 1988 and 2012 have had on neonatal mortality rates in Nova Scotia. Methods: Data on all infants delivered in Nova Scotia between January 1, 1988 and December 31, 2012 was extracted from the Nova Scotia Perinatal Atlee Database. Infant perinatal mortality and neonatal morbidity rates were calculated in 5-year time epochs and examined by delivery hospital classification (community, regional or tertiary), and maternal driving distance from hospital. Trends by epoch, delivery hospital and driving distance were examined. Results: From 1988 to 2012 perinatal mortality rates per 1000 for all births improved at both regional (from 9.8 to 5.7/1000) and tertiary hospitals (from 12.3 to 8.1/1000). Perinatal mortality rates for low risk births remained low and did not change significantly during this time period. Overall, neonatal morbidity rates fell across the province. Neonatal outcomes did not vary with increasing maternal distance from obstetrical services. Conclusions: Overall, infant perinatal morbidity and mortality outcomes have improved in Nova Scotia between 1988 and 2012. Regionalization of obstetrical care may have played a role in improving neonatal mortality rates among high-risk births. Increasing rural maternal isolation from obstetrical services did not impact infant perinatal mortality and morbidity outcomes when services remained available regionally.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".