Obstetric characteristics and neonatal outcome of unplanned out-of-hospital term deliveries: a prospective, case-control study.

To describe the obstetric characteristics and neonatal outcomes in unplanned out-of-hospital deliveries. Obstetric characteristics and neonatal outcomes were compared between 151 consecutive parturients with unplanned, out-of-hospital term deliveries and 151 hospital term deliveries. Women who delivered out of hospital tended to be older (32 +/- 5.5 vs. 28 +/- 5.0 years, p = 0.046) and less educated (4.4 +/- 5.1 vs. 6.5 +/- 5.0 years, p = 0.005) as compared to women who delivered in the hospital. Unplanned out-of-hospital deliveries resulted in statistically significant higher rate of low-birth-weight newborns (< 2,500 g) (OR= 3.9, 95% CI 2.0-7.7, p<0.001), postpartum hemorrhage (OR = 8.4, 95% CI 1.1-181.1, p = 0.018) and trended for higher rate of manual lysis of retained placenta and membranes (4.0% vs. 0%, p = 0.013). Higher rates of admission to the neonatal intensive care unit due to neonatal complications, such as polycythemia (12.6% vs. 0%, p < 0.001), hypoglycemia (9.3% vs. 0.6%, p = 0.001) and convulsions (3.3% vs. 0%, p = 0.024), were noted in the out-of-hospital delivery group as compared to the controls. Using a multivariable analysis, lower educational level (OR = 0.4, 95% CI 0.3-0.4, p < 0.001), maternal age > 35 (OR = 6.2, 95% CI 2.3-16.7, p < 0.001) and high parity (OR = 7.9, 95% CI 4.9-12.9, p<0.001) were found to be independent risk factors for an unplanned outof hospital delivery. Unplanned out-of-hospital birth is an important risk factor for such complications as postpartum hemorrhage, low birth weight and adverse neonatal outcome.

Citation

Amnon Hadar, Alex Rabinovich, Eyal Sheiner, Daniela Landau, Mordechai Hallak, Moshe Mazor. Obstetric characteristics and neonatal outcome of unplanned out-of-hospital term deliveries: a prospective, case-control study. The Journal of reproductive medicine. 2005 Nov;50(11):832-6

Mesh Tags

PMID: 16419631

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