Unplanned Out-of-Hospital Birth—Short and Long-Term Consequences for the Offspring

Gutvirtz, Gil; Wainstock, Tamar; Landau, Daniella

doi:10.3390/jcm9020339

Cited by 13 publications

(14 citation statements)

References 26 publications

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“…Our results could be explained, at least partly, by confounding effect of the differences in clinical practice and setting, regarding the venue of delivery (i.e., public or private hospital, and outside of the hospital). There is evidence that the venue of delivery is associated with mortality under 1 year of age [ 40 – 43 ]. Adverse birth outcomes were prevalent rather in the public hospitals compared with the private services.…”

Section: Discussionmentioning

confidence: 99%

“…Noticeably, the discrepancies resulted from suboptimal allocation of women to antenatal care in public hospitals in terms of perinatal mortality risk and/or delayed medical care [ 40 ]. Furthermore, it has been reported that unplanned out-of-hospital birth may be associated with an increases perinatal mortality, due to limited accessibility to certain urgent medical interventions or inadequate antenatal care [ 41 – 43 ]. Finally, the duration of the mother’s stay in the hospital may have been associated with birth outcomes [ 44 ], but the data were not available in the analyses, and might be included in future research agenda.…”

Section: Discussionmentioning

confidence: 99%

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Converging or diverging trajectories of mortality under one year of age in the Baltic States: a comparison with the European Union

et al. 2021

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Background Information about trends in perinatal and child health inequalities is scarce, especially in the Eastern Europe. We analyzed how mortality under 1 year of age has been changing in the Baltic States and the European Union (EU) over 25 years, and what associations occurred between changes in macroeconomic factors and mortality. Methods Data on fetal, neonatal, infant mortality, and macroeconomic factors were extracted from WHO database. Joinpoint regression analysis was performed to analyze time trajectories of mortality over 1990–2014. We also investigated how the changes in health expenditures and Gross Domestic Product (GDP) contributed to the changes in mortality. Results The reduction of fetal, neonatal and infant mortality in the Baltic countries led to convergence with the EU. In Estonia this process was the fastest, and then the rates tended to diverge. The strongest effect in reduction of neonatal mortality was related to the annual increase in health expenditure and GDP which had occurred in the same year, and a decrease in fetal mortality associated with an increase in health expenditure and GDP in the 4th and 5th year, respectively, following the initial change. Conclusions These findings outlined convergences and divergences in mortality under 1 year of age in the Baltic States compared with the patterns of the EU. Our data highlighted a need to define health policy directions aimed at the implementation of effective intervention modalities addressing reduction of risks in prenatal and early life.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Converging or diverging trajectories of mortality under one year of age in the Baltic States: a comparison with the European Union

et al. 2021

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“…Previous studies have shown that mothers who give birth unplanned out-of-hospital tend to be younger [5,17,24] or older [24][25][26][27], unmarried/not cohabiting [17,24,25], smoke during pregnancy [17,25], have less education or a lower socioeconomic status [17,27,28], more likely substance abusers [29], not visit or have fewer prenatal care visits [4,17,[30][31][32][33][34], and exhibit a lower length of gestation at delivery [5,24,25,28,30,35]. These are obviously risk factors for requiring future hospital care and disability allowances due to neurodevelopmental problems.…”

Section: Plos Onementioning

confidence: 99%

“…One study previously reported on the long-term morbidity of 3580 children born unplanned out-of-hospital in a single tertiary hospital area in Israel [4]. The study population included 243 682 singleton deliveries.…”

Section: Plos Onementioning

confidence: 99%

“…There are only a limited number of studies establishing the long-term outcomes of infants born out-of-hospital. A recently published study [4] showed that hospitalization rates were lower in UOHD children compared to those born in-hospital. Moreover, an Australian population-based cohort study showed that very preterm UOHD infants were significantly more likely to die within 28 days or one year of age compared to those born in-hospital.…”

Section: Introductionmentioning

confidence: 98%

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Is birth out-of-hospital associated with mortality and morbidity by seven years of age?

et al. 2021

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Background and aims Compared to in-hospital births, the long-term outcome of children born out-of-hospital, planned or unplanned, is poorly studied. This study aimed to examine mortality and morbidity by seven years of age in children born out-of-hospital compared to those born in-hospital. Methods This study was registered retrospectively and included 790 136 children born in Finland between 1996 and 2013. The study population was divided into three groups according to birth site: in-hospital (n = 788 622), planned out-of-hospital (n = 176), and unplanned out-of-hospital (n = 1338). Data regarding deaths, hospital visits, reimbursement of medical expenses, and disability allowances was collected up to seven years of age or by the year-end of 2018. The association between birth site and childhood morbidity was determined using multivariable-adjusted Cox hazard regression analysis. Results No deaths were reported during the first seven years after birth in the children born out-of-hospital. The percentage of children with hospital visits due to infection by seven years of age was lower in those born planned out-of-hospital and in the combined planned out-of-hospital and unplanned out-of-hospital group compared to those born in-hospital. Furthermore, the percentage of children with hospital visits and who received disability allowances due to neurological or mental disorders was higher among those born unplanned out-of-hospital and out-of-hospital in total when compared to those born in-hospital. In the multivariable-adjusted Cox proportional hazard regression analysis, the hazard ratio for hospital visits due to asthma and/or allergic diseases (HR 0.84; 95% CI 0.72–0.98) was lower in children born out-of-hospital when compared to those born in-hospital. A similar decreased risk was found due to infections (HR 0.76; 95% CI 0.68–0.84). However, the risk for neurological or mental health disorders was similar between the children born in-hospital and out-of-hospital. Conclusions Morbidity related to asthma or allergic diseases and infections by seven years of age appeared to be lower in children born out-of-hospital. Birth out-of-hospital seemed to not be associated with increased risk for neurological morbidity nor early childhood mortality. Our study groups were small and heterogeneous and because of this the results need to be interpreted with caution.

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Associations of unintended pregnancy with autism spectrum disorders and the modification of folic acid supplements

Chen,

Liu,

Lin

et al. 2023

Autism Research

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There is limited evidence on the associations of unintended pregnancy with autism spectrum disorders (ASD). This study aimed to examine this relationship and the modification of pre‐conceptional and prenatal folic acid supplements. Six thousand and five toddlers aged 16 to 30 months from seven cities of six provinces in China were eligible for participation. Information on unintended pregnancy and folic acid supplements was obtained via questionnaires from caregivers of toddlers. The diagnosis of ASD was based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM‐5) and the Chinese version of the Childhood Autism Rating Scale (CARS). Of the 6005 toddlers in the study (3337 boys and 2668 girls), 71 (1.18%) received the diagnosis of ASD. Generalized linear models with a logit link function showed unintended pregnancy was positively associated with ASD (odds ratios [OR] = 1.69, 95% confidence interval [CI], 1.05–2.79). Stratified estimates indicated that the association remained stable among toddlers of mothers without pre‐conceptional and prenatal folic acid supplements (OR = 2.75, 95% CI, 1.04–7.27; n = 1243, 20.70%). Unintended pregnancy was associated with higher odds of ASD in 16–30 months of toddlers, and the association was consistent among toddlers of mothers without prenatal folic acid supplements. Our findings emphasize the need to raise awareness of the risk of unintended pregnancy and the benefits of folic acid supplements among Chinese women.

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Unplanned Out-of-Hospital Birth—Short and Long-Term Consequences for the Offspring

Cited by 13 publications

References 26 publications

Converging or diverging trajectories of mortality under one year of age in the Baltic States: a comparison with the European Union

Converging or diverging trajectories of mortality under one year of age in the Baltic States: a comparison with the European Union

Is birth out-of-hospital associated with mortality and morbidity by seven years of age?

Associations of unintended pregnancy with autism spectrum disorders and the modification of folic acid supplements

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