The effect of medical and operative birth interventions on child health outcomes in the first 28 days and up to 5 years of age: A linked data population‐based cohort study

Peters, Lilian L.; Thornton, Charlene; Jonge, Ank de; Khashan, Ali S.; Tracy, Mark; Downe, Soo; Jong, Esther I. Feijen-de; Dahlen, Hannah G

doi:10.1111/birt.12348

Cited by 82 publications

(62 citation statements)

References 38 publications

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“…2,30 This issue is not confined to Australia, with a Lancet series recently noting high rates of Caesarean section and Caesarean section overuse as an international concern. 31 Australia's high Caesarean section rates are not only detrimental to both the short-and long-term health outcomes of women and their newborns, [32][33][34] but are also potentially detrimental to health system budgets given their high cost relative to vaginal birth demonstrated in the present study.…”

Section: Cost Of Maternity Care To Public Hospitalsmentioning

confidence: 68%

Cost of maternity care to public hospitals: a first 1000-days perspective from Queensland

et al. 2019

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Objective. This study sought to compare costs for women giving birth in different public hospital services across Queensland and their babies.Methods. A whole-of-population linked administrative dataset was used containing all health service use in a public hospital in Queensland for women who gave birth between 1 July 2012 and 30 June 2015 and their babies. Generalised linear models were used to compare costs over the first 1000 days between hospital and health services.Results. The mean unadjusted cost for each woman and her baby (n = 134 910) was A$17406 in the first 1000 days. After adjusting for clinical and demographic factors and birth type, women and their babies who birthed in the Cairns Hospital and Health Service (HHS) had costs 19% lower than those who birthed in Gold Coast HHS (95% confidence interval (CI) -32%, -4%); women and their babies who birthed at the Mater public hospitals had costs 28% higher than those who birthed at Gold Coast HHS (95% CI 8, 51).Conclusions. There was considerable variation in costs between hospital and health services in Queensland for the costs of delivering maternity care. Cost needs to be considered as an important additional element of monitoring programs.What is known about the topic? The Australian maternal care system delivers high-quality, safe care to Australian mothers. However, this comes at a considerable financial cost to the Australian public health system. It is known that there are variations in the cost of care depending upon the model of care a woman receives, and the type of delivery she has, with higher-cost treatment not necessarily being safer or producing better outcomes. What does this paper add? This paper compares the cost of delivering a full cycle of maternity care to a woman at different HHSs across Queensland. It demonstrates that there is considerable variation in cost across HHSs, even after adjusting for clinical and demographic factors. What are the implications for practitioners? Reporting of cost should be an ongoing part of performance monitoring in public hospital maternity care alongside clinical outcomes to ensure the sustainability of the high-quality maternal health care Australian public hospitals deliver.

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Section: Cost Of Maternity Care To Public Hospitalsmentioning

confidence: 68%

Cost of maternity care to public hospitals: a first 1000-days perspective from Queensland

et al. 2019

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“…There is a growing recognition that high levels of mortality and morbidity are co‐existing with excessive rates of intervention and failures in the quality of care across the childbearing continuum and into the early weeks of life. This is associated with iatrogenic damage in the short term, and possibly into the longer term and even transgenerational . There is also a global turn toward valuing positive outcomes of maternal and newborn care, and the reduction in negative outcomes …”

Section: Discussionmentioning

confidence: 99%

Asking different questions: A call to action for research to improve the quality of care for every woman, every child

Kennedy

Cheyney

Dahlen

et al. 2018

Birth

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Despite decades of considerable economic investment in improving the health of families and newborns world-wide, aspirations for maternal and newborn health have yet to be attained in many regions. The global turn toward recognizing the importance of positive experiences of pregnancy, intrapartum and postnatal care, and care in the first weeks of life, while continuing to work to minimize adverse outcomes, signals a critical change in the maternal and newborn health care conversation and research prioritization. This paper presents "different research questions" drawing on evidence presented in the 2014 Lancet Series on Midwifery and a research prioritization study conducted with the World Health Organization. The results indicated that future research investment in maternal and newborn health should be on "right care," which is quality care that is tailored to individuals, weighs benefits and harms, is person-centered, works across the whole continuum of care, advances equity, and is informed by evidence, including cost-effectiveness. Three inter-related research themes were identified: examination and implementation of models of care that enhance both well-being and safety; investigating and optimizing physiological, psychological, and social processes in pregnancy, childbirth, and the postnatal period; and development and validation of outcome measures that capture short and longer term well-being. New, transformative research approaches should account for the underlying social and political-economic mechanisms that enhance or constrain the well-being of women, newborns, families, and societies. Investment in research capacity and capability building across all settings is critical, but especially in those countries that bear the greatest burden of poor outcomes. We believe this call to action for investment in the three research priorities identified in this paper has the potential to achieve these benefits and to realize the ambitions of Sustainable Development Goal Three of good health and well-being for all.

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“…La hipótesis de la higiene extendida plantea que los bebés nacidos por cesárea tienen diferentes colonizaciones de la flora intestinal en comparación con aquellos nacidos por parto vaginal, lo cual puede afectar potencialmente la respuesta inmune neonatal. Y la hipótesis del impacto epigenético del parto se enfoca en los efectos del estrés causado por las intervenciones médicas (muy alto o muy bajo) sobre la regulación epigenética de la expresión génica en el sistema inmune 3,4 . Existe evidencia para plantear que en la salud a corto plazo, el nacimiento por cesárea se asocia a mayores casos de hipotermia, función pulmonar deteriorada, alteraciones del metabolismo y de presión sanguínea 3 .…”

Section: Sr Editorunclassified

Los efectos de la cesárea en la salud infantil: Un asunto urgente

Sadler

2018

Rev. chil. pediatr.

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The effect of medical and operative birth interventions on child health outcomes in the first 28 days and up to 5 years of age: A linked data population‐based cohort study

Cited by 82 publications

References 38 publications

Cost of maternity care to public hospitals: a first 1000-days perspective from Queensland

Cost of maternity care to public hospitals: a first 1000-days perspective from Queensland

Asking different questions: A call to action for research to improve the quality of care for every woman, every child

Los efectos de la cesárea en la salud infantil: Un asunto urgente

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