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Perinatal outcomes and travel time from home to hospital: W elsh data from 1995 to 2009
Author(s) -
Paranjothy Shantini,
Watkins W John,
Rolfe Kim,
Adappa Roshan,
Gong Yi,
Dunstan Frank,
Kotecha Sailesh
Publication year - 2014
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.12800
Subject(s) - medicine , odds ratio , logistic regression , confounding , demography , residence , singleton , home birth , odds , pediatrics , pregnancy , obstetrics , childbirth , sociology , biology , genetics
Aim To study the association between travel time from home to hospital and birth outcomes. Methods For all registrable births to women resident in Wales (1995–2009), we calculated the travel time between the mother's residence and the postcode‐based location for both the birth hospital and all hospitals with maternity services that were open. Using logistic regression, we obtained odds ratios for the association between travel time and each birth outcome, adjusted for confounders. Results In our analysis of 412 827 singleton births, for every 15‐min increase in travel time to the birth hospital, there was an increased risk of early (n = 609; OR : 1.13; 95% CI : 1.07, 1.20) and late neonatal death (n = 251; OR : 1.15; 95% CI : 1.05, 1.26). Results for intrapartum stillbirth were inconclusive (n = 135; OR : 1.13; 95% CI : 0.98, 1.30). For the above‐combined (n = 995) results, we get OR : 1.15, 95% CI : 1.09, 1.20. No association was found with travel time to the nearest hospital ( OR : 1.01; 95% CI : 0.90, 1.13 per 15‐min increase in travel time) for the composite outcome of intrapartum stillbirth and neonatal deaths. Conclusion Longer travel time to the birth hospital was associated with increased risk of neonatal deaths, but there was no strong evidence of association with the geographical location of maternity services.