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Accidental out‐of‐hospital deliveries: a case–control study
Author(s) -
Renesme L,
Garlantézec R,
Anouilh F,
Bertschy F,
Carpentier M,
Sizun J
Publication year - 2013
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/apa.12156
Subject(s) - medicine , accidental , pediatrics , pregnancy , obstetrics , retrospective cohort study , multivariate analysis , emergency medicine , surgery , genetics , physics , acoustics , biology
Aim To determine risk factors for accidental out‐of‐hospital deliveries ( OHD s), which represent 0.5% of live births in F rance and are associated with poor neonatal outcomes. Methods This retrospective case–control study assessed accidental OHD s that occurred in the F inistère D istrict ( B rittany, F rance) between J anuary 2007 and December 2009. For each OHD case, two controls were randomly selected. Outcome measures included maternal demographics, obstetric characteristics and neonatal outcomes. Results During the study period, accidental OHD s accounted for 0.42% of all births; 76 accidental OHD s were included in the analysis. Multivariate analysis found four independent risk factors for accidental OHD : multiparity [ OR : 8.84 (3.22–24.29)], unemployment [ OR : 4.99 (1.85–13.47)], lack of or poor antenatal care [ OR : 9.00 (2.41–33.72)] and a travel time >45 min from home to the delivery unit [ OR : 6.18 (1.33–28.65) versus < 15 min]. Significantly more newborns from the OHD group required admission to the neonatal unit (p = 0.04), but accidental OHD was not significantly associated with prematurity or low birth weight. Conclusion Four risk factors for accidental OHD were identified. Setting up an anonymous registry of OHD cases could improve our knowledge and screening of women at risk.