Locations and outcomes of premature births in Arkansas.

Most (57.6%) of the extremely premature infants were born at a hospital without the availability of neonatal and MFM specialists, and 38.4% of the very premature were born at a hospital without a neonatologist. Increasing evidence indicates that delivery at a Level 3 facility results in better survival for these high risk infants. Health professionals, administrators and policy leaders could fashion new approaches to obstetrical care in Arkansas to improve neonatal outcomes.