Ambulance Transfer in Case of Postpartum Hemorrhage after Birth in Primary Midwifery Care in The Netherlands: A Prospective Cohort Study

Stolp, Ineke; Smit, Marrit; Luxemburg, Sanne; Akker, Thomas van den; Waard, Jan de; Roosmalen, Jos van; Vos, Rien de

doi:10.1111/birt.12171

Cited by 3 publications

(5 citation statements)

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“…Moreover, we highlighted a hospital random effect, suggesting that all the variables included in our analysis can explain on their own the difference in mothers' or newborn's outcome. A few variables, sometimes identified as relevant in the literature and not included in our model may explain this effect, such as mothers' origin, 44 newborn's birthweight, 10 the need of an ambulance transfer, 45 or even consideration of out-of-hospital deliveries. 46,47 Finally, our results are backed up by those of larger countries with a centralized organization than ours.…”

Section: Discussionmentioning

confidence: 99%

In France, the organization of perinatal care has a direct influence on the outcome of the mother and the newborn: Contribution from a French nationwide study

Levaillant

Garabédian

Legendre

et al. 2023

Intl J Gynecology & Obste

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ObjectiveTo investigate maternal and neonatal outcomes after a delivery in France in 2019, according to hospital characteristics and the impact of distance and time of travel on mother and newborn.MethodsAll parturients above 18 years of age who delivered in 2019 and were identified in the French health insurance database were included, with their newborns, in this retrospective cohort study. Main outcome measures were Severe Maternal Morbidity score and the Neonatal Adverse Outcome Indicator (NAOI).ResultsAmong the 733 052 pregnancies included, 10 829 presented a severe maternal morbidity (1.48%) and 77 237 had a neonatal adverse outcome (10.4%). Factors associated with an unfavorable maternal or neonatal outcome were Obstetric Comorbidity Index, primiparity, and cesarean or instrumental delivery. Prematurity was associated with less severe maternal morbidity but more neonatal adverse outcomes. Time of travel above 30 min was associated with a higher NAOI rate.ConclusionsResults suggest the efficiency of regionalization of perinatal care in France, although a difference in both outcomes persists according to unit volume, suggesting the need for a further step in concentrating perinatal care. Perinatal care organization should focus on mapping the territory with high‐level, high‐volume maternity throughout the territory; this suggests closing down high‐volume units and improving low‐volume ones to maintain coherent mapping.

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Section: Discussionmentioning

confidence: 99%

In France, the organization of perinatal care has a direct influence on the outcome of the mother and the newborn: Contribution from a French nationwide study

Levaillant

Garabédian

Legendre

et al. 2023

Intl J Gynecology & Obste

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“…Evidence from travel time studies Description of included studies Fifteen studies explored the impact of travel time from a woman's home to an OU (see table 7). Two studies (one reported as an abstract only) were conducted in the UK, [29][30][31] three studies in France, [32][33][34] three studies (reported in five articles) in the Netherlands, [35][36][37][38][39] one study reported in two articles from Norway, 40 41 five studies in Canada [42][43][44][45][46] and one study in Japan. 47 Eleven studies were of a retrospective cohort design, one was a prospective cohort study, 39 one was a before-and-after design 47 and two were case-control studies.…”

Section: Hypoxic-ischaemic Encephalopathy (Hie)mentioning

confidence: 99%

“…Only singleton births were included in five studies. 30-32 35-38 42 One study 39 specifically enrolled women with postnatal haemorrhage after home birth, and one study 42 focused on planned home birth regardless of the actual place of birth.…”

Section: Hypoxic-ischaemic Encephalopathy (Hie)mentioning

confidence: 99%

“…However, most studies estimated travel duration to and from central points within areas rather than actual addresses. 39 sample selection and measurement of outcomes were considered to be at low risk of bias across all studies as such data were obtained from national databases and birth registries. The groups in the two case-control studies were appropriately selected and defined, however, the case and control groups were not comparable in both studies (eg, difference in antenatal care attendance and sociodemographics).…”

Section: Hypoxic-ischaemic Encephalopathy (Hie)mentioning

confidence: 99%

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Impact of obstetric unit closures, travel time and distance to obstetric services on maternal and neonatal outcomes in high-income countries: a systematic review

et al. 2020

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ObjectivesTo systematically review (1) The effect of obstetric unit (OU) closures on maternal and neonatal outcomes and (2) The association between travel distance/time to an OU and maternal and neonatal outcomes.DesignSystematic review of any quantitative studies with a comparison group.Data sourcesEmbase, MEDLINE, PsycINFO, Applied Social Science Index and Abstracts, Cumulative Index to Nursing and Allied Health and grey literature were searched.MethodsEligible studies explored the impact of closure of an OU or the effect of travel distance/time on prespecified maternal or neonatal outcomes. Only studies of women giving birth in high-income countries with universal health coverage of maternity services comparable to the UK were included. Identification of studies, extraction of data and risk of bias assessment were undertaken by at least two reviewers independently. The risk of bias checklist was based on the Cochrane Effective Practice and Organisation of Care criteria and the Newcastle-Ottawa scale. Heterogeneity across studies precluded meta-analysis and synthesis was narrative, with key findings tabulated.Results31 studies met the inclusion criteria. There was some evidence to suggest an increase in babies born before arrival following OU closures and/or associated with longer travel distances or time. This may be associated with an increased risk of perinatal or neonatal mortality, but this finding was not consistent across studies. Evidence on other maternal and neonatal outcomes was limited but did not suggest worse outcomes after closures or with longer travel times/distances. Interpretation of findings for some studies was hampered by concerns around how accurately exposures were measured, and/or a lack of adjustment for confounders or temporal changes.ConclusionIt is not possible to conclude from this review whether OU closure, increased travel distances or times are associated with worse outcomes for the mother or the baby.PROSPERO registration numberCRD42017078503.

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“…Timeliness refers to the geographical distribution of resources, and the distance and time to reach them. As such, transportation is emphasized as essential to achieve timely care [62][63][64][65][66]. Availability of resources includes availability of expertise, facility, technology, diagnostics and therapy [67][68][69][70][71][72][73][74].…”

Section: Risk Selection As An Organisational Measure: Aligning Risk Amentioning

confidence: 99%

Towards a better understanding of risk selection in maternal and newborn care: A systematic scoping review

et al. 2020

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Globally, millions of women and their children suffer due to preventable morbidity and mortality, associated with both underuse and overuse of maternal and newborn care. An effective system of risk selection that differentiates between what care should be provided and who should provide it is a global necessity to ensure women and children receive appropriate care, at the right place and the right time. Poor conceptualization of risk selection impedes evaluation and comparison of models of risk selection across various settings, which is necessary to improve maternal and newborn care. We conducted a scoping review to enhance the understanding of risk selection in maternal and newborn care. We included 210 papers, published over the past four decades, originating from 24 countries. Using inductive thematic analysis, we identified three main dimensions of risk selection: (1) risk selection as an organisational measure to optimally align women's and children's needs and resources, (2) risk selection as a practice to detect and assess risk and to make decisions about the delivery of care, and (3) risk selection as a tool to ensure safe care. We found that these three dimensions have three themes in common: risk selection (1) is viewed as both requiring and providing regulation, (2) has a provider centred focus and (3) aims to avoid underuse of care. Due to the methodological challenges of contextual diversity, the concept of risk selection needs clear indicators that capture the complexity of care to make crosssetting evaluation and comparison of risk selection possible. Moreover, a comprehensive understanding of risk selection needs to consider access disparity, women's needs, and unnecessary medicalization.

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Ambulance Transfer in Case of Postpartum Hemorrhage after Birth in Primary Midwifery Care in The Netherlands: A Prospective Cohort Study

Abstract: We found no relation between the duration of ambulance transfer and maternal condition or outcomes. All women fully recovered. The low-risk profile of women in primary care, well-organized midwifery, and ambulance care in The Netherlands are likely to contribute to these findings.

Cited by 3 publications

References 25 publications

In France, the organization of perinatal care has a direct influence on the outcome of the mother and the newborn: Contribution from a French nationwide study

In France, the organization of perinatal care has a direct influence on the outcome of the mother and the newborn: Contribution from a French nationwide study

Impact of obstetric unit closures, travel time and distance to obstetric services on maternal and neonatal outcomes in high-income countries: a systematic review

Towards a better understanding of risk selection in maternal and newborn care: A systematic scoping review

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