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

Amnon Hadar, Alex Rabinovich, Eyal Sheiner, Daniela Landau, Mordechai Hallak, Moshe Mazor

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

OBJECTIVE: To describe the obstetric characteristics and neonatal outcomes in unplanned out-of-hospital deliveries. STUDY DESIGN: Obstetric characteristics and neonatal outcomes were compared between 151 consecutive parturients with unplanned, out-of-hospital term deliveries and 151 hospital term deliveries. RESULTS: 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 out-of hospital delivery. CONCLUSION: Unplanned out-of-hospital birth is an important risk factor for such complications as post-partum hemorrhage, low birth weight and adverse neonatal outcome.

Original languageEnglish
Pages (from-to)832-836
Number of pages5
JournalThe Journal of reproductive medicine
Volume50
Issue number11
StatePublished - 1 Nov 2005
Externally publishedYes

Keywords

  • Delivery
  • Pregnancy complications
  • Pregnancy outcome
  • Unplanned out-of-hospital deliveries

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

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