Perinatal outcomes and travel time from home to hospital: Welsh data from 1995 to 2009
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Shantini Paranjothy1, W John Watkins, Kim Rolfe
1Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, UK.
Aim:
To study the association between travel time from home to hospital and birth outcomes.
Methods:
For all registrable births to women resident in Wales (1995-2009), we calculated the travel time between the mother's residence and the postcode-based location for both the birth hospital and all hospitals with maternity services that were open. Using logistic regression, we obtained odds ratios for the association between travel time and each birth outcome, adjusted for confounders.
Results:
In our analysis of 412 827 singleton births, for every 15-min increase in travel time to the birth hospital, there was an increased risk of early (n = 609; OR: 1.13; 95%CI: 1.07, 1.20) and late neonatal death (n = 251; OR: 1.15; 95%CI: 1.05, 1.26). Results for intrapartum stillbirth were inconclusive (n = 135; OR: 1.13; 95%CI: 0.98, 1.30). For the above-combined (n = 995) results, we get OR: 1.15, 95%CI: 1.09, 1.20. No association was found with travel time to the nearest hospital (OR: 1.01; 95%CI: 0.90, 1.13 per 15-min increase in travel time) for the composite outcome of intrapartum stillbirth and neonatal deaths.
Conclusion:
Longer travel time to the birth hospital was associated with increased risk of neonatal deaths, but there was no strong evidence of association with the geographical location of maternity services.
