Out-of-hospital births in California 1991–2011

Girsén, Anna; Mayo, Jonathan A.; Lyell, Deirdre J.; Blumenfeld, YJ; Stevenson, David K.; El‐Sayed, Yasser Y.; Shaw, Gary M.; Druzin, Maurice L.

doi:10.1038/jp.2017.156

Cited by 9 publications

(10 citation statements)

References 13 publications

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“…All emergency medical services (EMS) manage calls for unplanned out-of-hospital births 1–4 . Prevalence is estimated to be 0.61% of all deliveries in the United States [7], 0.19 and 0.42% in two different studies in France, and 0.10% in Finland [3, 8, 11]. Most of previous works investigated out-of-hospital births without discriminating planned or unplanned births [16–21].…”

Section: Discussionmentioning

confidence: 99%

“…This specific context must be discriminated from planned out-of-hospital births, home births or freestanding birthing centers, where midwife management is performed [6]. Globally, unplanned out-of-hospital births prevalence is estimated to be 0.19 to 0.61% of all deliveries [7, 8].…”

Section: Introductionmentioning

confidence: 99%

“…Out-of-hospital delivery is associated with unfavorable perinatal outcome and increased mortality [9–11]. Hypothermia is the most frequently described adverse outcome [7, 8]. However, knowledge is limited by the small sample size of the previous studies, and most of them had insufficient power to accurately assess adverse events [12, 13].…”

Section: Introductionmentioning

confidence: 99%

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Unplanned out-of-hospital birth and risk factors of adverse perinatal outcome: findings from a prospective cohort

Javaudin

Hamel

Legrand³

et al. 2019

Scand J Trauma Resusc Emerg Med

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Background In France, while most babies are delivered at hospital, emergency medical services (EMS) weekly manage calls for unplanned out-of-hospital births. The objective of our study was to describe neonatal morbidity and mortality, defined as death or neonatal intensive care unit hospitalization at Day 7, in a prospective multicentric cohort of unplanned out-of-hospital births. Methods We prospectively analyzed out-of-hospital births from 25 prehospital EMS units in France. The primary outcome was neonatal morbidity and mortality, and the secondary outcome was risk factors associated with neonatal morbidity and mortality. A univariate logistic regression was first made, followed by a multivariate logistic regression with backward selection. Results From October 2011 to August 2018, a total of 1670 unplanned out-of-hospital births were included. Of these, 1652 (99.2%) were singleton and 1537 (93.5%) had prenatal care. Maternal mean age of the study population was 30 ± 5.5 (range 15 to 48). The majority of women were multiparous, but 13% were nulliparous. Overall, 45.3% of these unplanned out-of-hospital births were medically-driven, either by phone during medical regulation (12.5%) or on scene by the prehospital emergency medical service units (32.9%). The prevalence of neonatal morbidity and mortality was 6.3% ( n = 106) after an unplanned out-of-hospital birth (death before Day 7: n = 20; 1.2%). The multivariate logistic regression found that multiparity (adjusted Odds Ratio = 70.7 [4.7–1062]), prematurity (adjusted Odds Ratio = 6.7 [2.1–21.4]), maternal pathology (adjusted Odds Ratio = 2.8 [1.0–7.5]) and hypothermia (adjusted Odds Ratio = 2.8 [1.1–7.6]) were independent predictive factors of neonatal morbidity and mortality. Conclusions Our study assessed for the first time risk factors for adverse perinatal outcome in a large and multicenter cohort of unplanned out-of-hospital births. We have to improve temperature management in the out-of-hospital field and future trials are required to investigate strategies to optimize newborns management in the prehospital area. Electronic supplementary material The online version of this article (10.1186/s13049-019-0600-z) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Unplanned out-of-hospital birth and risk factors of adverse perinatal outcome: findings from a prospective cohort

Javaudin

Hamel

Legrand³

et al. 2019

Scand J Trauma Resusc Emerg Med

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“…The prevalence of unplanned out-of-hospital births (UOHB) is estimated to represent 0.6% of all deliveries in the United States, 1 to 2% in the UK and 0.5% in France [1,2]. UOHB are defined as births without midwife and medical care, or without optimal health care conditions [3].…”

Section: Introductionmentioning

confidence: 99%

“…Out-of-hospital delivery is associated with unfavorable perinatal outcomes and increased mortality [2,5,6], with hypothermia being the most frequently described adverse outcome [1,7,8]. Indeed, hypothermia is recognized as a significant risk factor for mortality under these conditions [9,10].…”

Section: Introductionmentioning

confidence: 99%

Assessment of rewarming methods in unplanned out-of-hospital births from a prospective cohort

Javaudin

Roche

Trutt

et al. 2020

Scand J Trauma Resusc Emerg Med

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Background: Mobile intensive care units frequently manage unplanned out-of-hospital births (UOHB). Rewarming methods during pre-hospital management of UOHB have not yet been compared. The aim was to compare rewarming methods used during pre-hospital management in a large prospective cohort of UOHB in France. Methods: We analysed UOHB from the prospective AIE cohort from 25 prehospital emergency medical services in France. The primary outcome was the change in body temperature from arrival at scene to arrival at hospital. Results: From 2011 to 2018, 1854 UOHB were recorded, of whom 520 were analysed. We found that using incubator care was the most effective rewarming method (+ 0.8°C during transport), followed by the combination of plastic bag, skin-to-skin and cap (+ 0.2°C). The associations plastic bag + cap and skin-to-skin + cap did not allow the newborn to be warmed up but rather to maintain initial temperature (+ 0.0°C). The results of the multivariate model were consistent with these observations, with better rewarming with the use of an incubator. We also identified circumstances of increased risk of hypothermia according to classification and regression tree, like premature birth (< 37 weeks of gestation) and/or low outside temperature (< 8.4°C). Conclusions: Using an incubator was the most effective rewarming method during pre-hospital management of UOHB in our French prospective cohort. Based on our model, in cases of term less than 37 weeks of gestation or between 37 and 40 weeks with a low outside temperature or initial hypothermia, using such a method would be preferred.

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Childbirth emergencies

Jameson¹,

Campbell²

2021

Emergency Medical Services

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Out-of-hospital births in California 1991–2011

Abstract: California birth records from a 20-year period show an increase in out-of-hospital births from years 2005 to 2011, following a period of decline from 1991 to 2004.

Cited by 9 publications

References 13 publications

Unplanned out-of-hospital birth and risk factors of adverse perinatal outcome: findings from a prospective cohort

Unplanned out-of-hospital birth and risk factors of adverse perinatal outcome: findings from a prospective cohort

Assessment of rewarming methods in unplanned out-of-hospital births from a prospective cohort

Childbirth emergencies

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