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Very preterm birth before arrival at hospital
Rosemarie Anne Boland1,2,3, Peter Graham Davis1,2,4, Jennifer Anne Dawson1,2,4
1Clinical Sciences, Murdoch Children's Research Institute, Parkville, Victoria, Australia.
The Australian & New Zealand Journal of Obstetrics & Gynaecology
|September 1, 2017
Summary
Very preterm births before arrival (BBAs) are more common in teenagers and have higher mortality risks. These births, occurring outside a hospital, are linked to increased stillbirth and infant death rates compared to hospital births.
Area of Science:
- Perinatal Medicine
- Neonatology
- Public Health
Background:
- Births before arrival (BBAs) at a hospital present unique perinatal challenges.
- Understanding the characteristics and outcomes of BBAs is crucial for improving neonatal care.
Purpose of the Study:
- To characterize very preterm births before arrival (BBAs).
- To compare perinatal and infant mortality rates of BBAs with hospital births up to one year.
Main Methods:
- Population-based cohort study in Victoria, Australia (1990-2009).
- Analysis of 22-31 weeks' gestation births, defining BBAs as unintentional out-of-hospital births.
- Logistic regression used to compare mortality, adjusting for gestational age, birthweight, and sex.
Main Results:
- 133 BBAs identified, with 38% stillbirths and 62% livebirths.
- BBAs were more premature (26.3 vs. 27.7 weeks) and more frequent in teenage mothers (13% vs. 5%).
- BBAs had significantly higher risks of stillbirth (aOR 2.13), 28-day mortality (aOR 2.97), and one-year mortality (aOR 2.87) compared to hospital births.
Conclusions:
- Very preterm birth before arrival is associated with increased mortality risks.
- Teenage mothers are disproportionately affected by BBAs.
- Interventions are needed to reduce the incidence and improve outcomes of BBAs.
