The impact of increased number of low-risk deliveries on maternal and neonatal outcomes: A retrospective cohort study in Finland in 2011-2015

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Karalis , E , Tapper , A-M , Gissler , M & Ulander , V-M 2018 , ' The impact of increased number of low-risk deliveries on maternal and neonatal outcomes: A retrospective cohort study in Finland in 2011-2015 ' , European Journal of Obstetrics, and Gynecology ,and Reproductive Biology , vol. 223 , pp. 30-34 . https://doi.org/10.1016/j.ejogrb.2018.02.007

Title: The impact of increased number of low-risk deliveries on maternal and neonatal outcomes: A retrospective cohort study in Finland in 2011-2015
Author: Karalis, Elina; Tapper, Anna-Maija; Gissler, Mika; Ulander, Veli-Matti
Contributor: University of Helsinki, Department of Obstetrics and Gynecology
University of Helsinki, Department of Obstetrics and Gynecology
Date: 2018-04
Language: eng
Number of pages: 5
Belongs to series: European Journal of Obstetrics, and Gynecology ,and Reproductive Biology
ISSN: 0301-2115
URI: http://hdl.handle.net/10138/298989
Abstract: Objectives: Our aim was to demonstrate the influence of increased number of low-risk deliveries on obstetric and neonatal outcome. Study design: The study hospital was Katiloopisto Maternity Hospital in Helsinki. Simultaneously, we studied all three delivery units in the Helsinki region in the population-based analysis. The study population was singleton hospital deliveries occurring between 2011 and 2012, and 2014-2015. The study hospital included 11 237 and 15 637 births and the population-based group included 28 950 and 27 979 births. We compared outcome measures in different periods by calculating adjusted odds ratios (AOR). Main outcome measures were induced delivery, mode of delivery, third or fourth degree perinea, tear, Apgar score at five minutes 7 days, and perinatal death. Results: In the study hospital, induction rate increased from 22.4% to 24.8% (AOR 1.06, 95% CI; 1.00-1.12) while in the population-based analysis the rate decreased from 22.2% to 21.5% (AOR 0.96, 95% CI; 0.92-1.00). Percentage of neonatal transfers, low Apgar scores, and severe perineal tears increased both in study hospital and in population-based group. Changes in operative delivery rate and other adverse perinatal outcomes were statistically insignificant. Conclusions: Increasing the volume of a delivery unit does not compromise maternal or neonatal outcome. Specific characteristics of a delivery unit affect the volume outcome association. (C) 2018 Elsevier B.V. All rights reserved.
Subject: BIRTHS
DEATHS
HOSPITAL VOLUME
Hospital safety
LEVEL
MORBIDITY
MORTALITY
Maternity unit size
Neonatal asphyxia
Neonatal death
Perinatal death
SPECIALIZATION
3123 Gynaecology and paediatrics
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