Transfers to hospital in planned home birth in four Nordic countries – a prospective cohort study

Blix, Ellen; Kumle, Merethe; Ingversen, Karen; Huitfeldt, Anette Schaumburg; Hegaard, Hanne Kristine; Ólafsdóttir, Ólöf Ásta; Øian, Pål; Lindgren, Helena

doi:10.1111/aogs.12858

Cited by 37 publications

(43 citation statements)

References 13 publications

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“…Qualitative research from New Zealand and Canada suggests that women living in rural and remote areas in high‐income countries consider issues of safety when making decisions regarding where to give birth, highlighting the need for good information to inform these decisions. Although several studies have examined rates, indications, and duration of transfer to a hospital from out‐of‐hospital settings, we were unable to identify research from high‐income settings that examined the association between duration of transfer to a hospital for individuals planning home births and their clinical outcomes. A small Canadian study reporting the outcomes of rural parturient women with a midwife involved in their care included births that were planned to take place at home at a distance of more than one hour from hospital, but outcomes were reported by maternal residence rather than by planned place of birth .…”

Section: Discussionmentioning

confidence: 99%

Distance from Home Birth to Emergency Obstetric Services and Neonatal Outcomes: A Cohort Study

Darling¹,

Lawford²,

Wilson³

et al. 2018

J Midwife Womens Health

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Introduction Little is known about the relationship between distance from hospital services and the outcomes of planned home births. We examined whether greater driving distance from a hospital with continuous cesarean capability was associated with a higher risk of adverse neonatal outcome among individuals who were planning to give birth at home. Methods Using an intention‐to‐treat analysis, we conducted a population‐based cohort study of 11,869 individuals who planned to give birth at home in Ontario, Canada, between April 1, 2012, and March 31, 2015. We used postal codes to determine the driving time from maternal residence to the closest hospital offering level 2 or higher maternity care services (ie, hospital with continuous cesarean birth capability). We used log binomial regression analysis to compare the outcomes of individuals who planned a birth more than a 30‐minute drive from a level 2 hospital with those of individuals whose births were planned to occur within 30 minutes. We adjusted for maternal age, parity, gestational age, season, and maternal material deprivation quintile. Results We found no statistically significant difference in the rates of 5‐minute Apgar scores less than 7 (adjusted relative risk [aRR], 1.02; 95% CI, 0.95‐1.10; P = .58), perinatal mortality, meconium aspiration syndrome, and emergency medical service usage. Neonates born to individuals who planned to give birth at a greater distance from a hospital had a lower rate of neonatal intensive care unit admission (aRR, 0.6; 95% CI, 0.44‐0.81; P = .001). Discussion We found no increased risk of adverse neonatal outcomes for births that were planned to occur more than 30 minutes from a hospital. Our findings can be considered, along with individual risk factors and contextual factors, in decision making about the choice of home birth for individuals who live more than half an hour from a hospital with cesarean capacity.

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Section: Discussionmentioning

confidence: 99%

Distance from Home Birth to Emergency Obstetric Services and Neonatal Outcomes: A Cohort Study

Darling¹,

Lawford²,

Wilson³

et al. 2018

J Midwife Womens Health

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“…Besides the Netherlands, rates of planned out-of-hospital birth (i.e., births intended to occur at home or at a freestanding birth center) have increased in high- and middle-income countries [24,25,26]. In addition, there is an increasing tendency toward early discharge after uncomplicated deliveries in hospital [13].…”

Section: Discussionmentioning

confidence: 99%

Reliability and Validity of a Smartphone-Paired Pulse Oximeter for Screening of Critical Congenital Heart Defects in Newborns

Huizing

Villamor-Martínez²,

Chavagne³

et al. 2017

Neonatology

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Background: Barriers to widespread implementation of pulse oximetry screening of critical congenital heart defects (CCHD) in newborns include increasing trends of out-of-hospital births and cost of equipment. In recent years, smartphone-compatible pulse oximeters have appeared on the market, but the validity of such devices in the setting of CCHD screening has not been evaluated. Objectives: To compare the performance in CCHD screening of a smartphone-paired pulse oximeter (Masimo iSpO₂-Rx™) and a hospital-grade pulse oximeter (Masimo Radical-7™). Methods: Preductal (right hand) and postductal (either foot) saturations were determined in a population of 201 term newborns by 2 independent teams, one using the Radical-7 and the other using the iSpO₂-Rx. Bland-Altman analysis was applied to calculate mean bias and 95% limits of agreement between the 2 pulse oximeters. Results: For the preductal oxygen saturation, the mean bias (Radical-7 minus iSpO₂-Rx) was -0.08 (SD 1.76) and the lower and upper limits of agreement were -3.52 and 3.36, respectively. For the postductal oxygen saturation, the mean bias was -0.11 (SD 1.68) and the lower and upper limits of agreement were -3.49 and 3.18, respectively. In addition, the iSpO₂-Rx provided reliable measurements of saturations below 95% in a group of 12 infants admitted to the neonatal intensive care unit. Conclusions: Our data suggest that CCHD screening with the Masimo iSpO₂-Rx is feasible and accurate. The use of reliable smartphone-paired pulse oximeters may contribute to the extension of CCHD screening to home births and low resource settings.

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“…Det er eksempelvis påbudt å sikre barn i bil, da skadeomfang reduseres med 70-80 % og dødsrisikoen med nesten 30 % ved en trafikkulykke (7). I en skandinavisk studie med 3 068 planlagte hjemmefødsler måtte 364 fødende og 38 nyfødte barn flyttes til sykehus i løpet av fødselen (8). Av disse var nesten en tredjedel hasteforflytninger grunnet dårlig fosterlyd, alvorlig blødning hos mor eller en kritisk syk nyfødt.…”

Section: Tryggest For Barnetunclassified

Hjemmefødsler innebærer unødvendig risiko

Nordseth¹

2019

Tidsskriftet

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Transfers to hospital in planned home birth in four Nordic countries – a prospective cohort study

Abstract: Introduction. Women planning for home birth are transferred to hospital in case of

Cited by 37 publications

References 13 publications

Distance from Home Birth to Emergency Obstetric Services and Neonatal Outcomes: A Cohort Study

Distance from Home Birth to Emergency Obstetric Services and Neonatal Outcomes: A Cohort Study

Reliability and Validity of a Smartphone-Paired Pulse Oximeter for Screening of Critical Congenital Heart Defects in Newborns

Hjemmefødsler innebærer unødvendig risiko

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