Comparing Perinatal Outcomes for Healthy Pregnant Women Presenting at Primary and Tertiary Settings in South Auckland: A Retrospective Cohort Study

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aut.relation.endpage13
aut.relation.issue55en_NZ
aut.relation.journalNew Zealand College of Midwives Journalen_NZ
aut.relation.startpage5
aut.researcherClemons, Janine Helen
dc.contributor.authorFarry, Aen_NZ
dc.contributor.authorMcAra-Couper, Jen_NZ
dc.contributor.authorWheldon, Men_NZ
dc.contributor.authorClemons, JHen_NZ
dc.date.accessioned2020-07-01T00:33:42Z
dc.date.available2020-07-01T00:33:42Z
dc.date.copyright2019en_NZ
dc.date.issued2019en_NZ
dc.description.abstractABSTRACT Background: Strong evidence supports the premise that many low-risk women and babies experience perinatal outcomes, in a free-standing, midwifery-led, primary level maternity unit (PMU) similar to, or better than, those of an obstetric-led tertiary level maternity hospital (TMH). Aim: The aim of this study was to identify whether place of birth affected measurable maternal and neonatal outcomes in a low-risk cohort within one New Zealand District Health Board. Method: We gathered the birth records of a retrospective cohort of low-risk women (n=4,207), who had birthed within two distinct environments, including one TMH and three PMUs. Comparison was made of three maternal outcomes: emergency caesarean section, acute postpartum admission to theatre/high dependency unit/intensive care unit (<12hr post birth) and postpartum haemorrhage (PPH; >500ml). Neonatal outcomes analysed were 5-min Apgar score <7 and acute neonatal admission to neonatal intensive care unit (NICU; <12hr post birth). Findings: Logistic regression of data revealed statistically significant associations between place of birth and the five perinatal outcomes. Low-risk women giving birth in one of the three PMUs had fewer emergency caesarean sections (OR 0.25, 95% CI, 0.157-0.339), PPHs (OR 0.692, 95% CI, 0.534-0.898), and acute postpartum admissions to theatre (OR 0.201, 95% CI, 0.102-0.398) than women giving birth in the TMH. Babies born to women at a PMU were less likely to experience a 5-min Apgar <7 (OR 0.313, 95% CI, 0.124-0.791) or acute neonatal admission to NICU (OR 0.492, 95% CI, 0.324-0.747) compared to babies of women of similar risk status, born in the TMH. Conclusion: Low-risk women birthing in PMUs in South Auckland, New Zealand, experienced a significant reduction in morbidity for themselves and their babies.en_NZ
dc.identifier.citationNew Zealand College of Midwives Journal, 55, pp. 5-13. https://doi.org/10.12784/nzcomjnl55.2019.1.5-13
dc.identifier.doi10.12784/nzcomjnl55.2019.1.5-13en_NZ
dc.identifier.issn0114-7870en_NZ
dc.identifier.urihttps://hdl.handle.net/10292/13474
dc.languageEnglishen_NZ
dc.publisherNew Zealand College of Midwivesen_NZ
dc.relation.urihttps://www.midwife.org.nz/wp-content/uploads/2019/03/Jnl-55-article-1-Comparing-perinatal-outcomes.pdf
dc.rightsThe Journal is double-blind peer reviewed and uses electronic, article-based publishing to provide open access to all papers as they are published. It is then printed in full in December each year and circulated to all College members and subscribers.
dc.rights.accessrightsOpenAccessen_NZ
dc.subjectPlace of Birthen_NZ
dc.subjectPrimary birthing uniten_NZ
dc.subjectTertiary maternity hospitalen_NZ
dc.subjectCaesarean sectionen_NZ
dc.subjectNeonatal morbidityen_NZ
dc.subjectTransfer ratesen_NZ
dc.titleComparing Perinatal Outcomes for Healthy Pregnant Women Presenting at Primary and Tertiary Settings in South Auckland: A Retrospective Cohort Studyen_NZ
dc.typeJournal Article
pubs.elements-id357420
pubs.organisational-data/AUT
pubs.organisational-data/AUT/Health & Environmental Science
pubs.organisational-data/AUT/Health & Environmental Science/Clinical Sciences
pubs.organisational-data/AUT/PBRF
pubs.organisational-data/AUT/PBRF/PBRF Health and Environmental Sciences
pubs.organisational-data/AUT/PBRF/PBRF Health and Environmental Sciences/HH Clinical Sciences 2018 PBRF
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