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Out‐of‐hospital deliveries have risen involving greater neonatal morbidity
Author(s) -
Ovaskainen Katja,
Ojala Riitta,
Gissler Mika,
Luukkaala Tiina,
Tammela Outi
Publication year - 2015
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.13117
Subject(s) - medicine , pediatrics , neonatal mortality , emergency medicine , intensive care medicine , infant mortality , environmental health , population
Aim Most Finnish births take place in hospital, but out‐of‐hospital deliveries ( OHD s) have increased. This study evaluated trends and reasons for OHD s in the Tampere University Hospital catchment area. Methods The study cohort included all planned and unplanned OHD s in the Hospital area from 1996 to 2011; the control group comprised two hospital births for each OHD . Trends in incidence and risk factors for OHD s, including neonatal morbidities, were established and compared to the controls. Results OHD s accounted for 67 (0.10%) of the 76 773 births in the area, the proportion remaining unchanged between 1996 and 2005, but then increasing. Risk factors associated with OHD s were smoking during pregnancy, short labour, higher number of previous births, single status, residence more than 35 kilometres from the delivery unit and fewer prenatal visits. OHD cases were more likely to be admitted to the neonatal care unit than controls and to be treated for suspected infections and hypothermia. Conclusion Smoking, short duration of labour, a higher number of previous births, single status and longer distances from the delivery unit were associated with OHD s. Eight (12%) mothers had OHD s without antenatal care, and their infants had more neonatal morbidities.