Researchers at the School of Medicine have found that many at-risk babies born in California do not receive the follow-up care that is expected for their high-risk status.

In a study published in the February issue of The Journal of Pediatrics, lead author Susan Hintz, professor of neonatal and developmental medicine, and her collaborators determined that 20 percent of very-low-birth-weight babies born in the state between 2010 and 2011 were not referred to the state’s high-risk infant follow-up program.

Very-low-birth-weight babies are those who weigh less than 3.3 pounds at birth. These babies are often born prematurely and at risk for neurologic and developmental problems.

All such babies who received care in a California Children’s Services-approved neonatal facility after birth qualify for a state-supported follow-up program. In the program, babies receive diagnostic assessments and other pediatrics services until age three.

Researchers collected data on 10,433 very-low-birth-weight babies, 8,071 of whom survived to hospital discharge and 6,424 of whom got referrals to follow-up care.

The babies most likely to be referred were those born prematurely, were small at birth, experienced medical problems or illness in the hospital, or underwent surgery.

By hospital, those with the largest patient volume averaged 85 percent of infants getting a follow-up care referral, while hospitals with lower patient volumes averaged a referral rate of 65 percent (with referral rates ranging quite a bit between individual hospitals).

Stanford researchers collaborated with researchers at the California Perinatal Quality of Care Collaborative and the California Department of Health Care Services.