Journal article
Neonatal admission and mortality in babies born in UK alongside midwifery units: a national population-based case-control study using the UK Midwifery Study System (UKMidSS)
- Abstract:
-
Objectives: To determine the incidence of and risk factors for neonatal unit admission, intrapartum stillbirth, or neonatal death without admission, and describe outcomes, in babies born in an alongside midwifery unit (AMU).
Design: National population-based case-control study.
Method: We used the UK Midwifery Study System to identify and collect data about 1041 women who gave birth in AMUs, March 2017 to February 2018, whose babies were admitted to a neonatal unit or died (cases), and 1984 controls from the same AMUs. We used multivariable logistic regression, generating adjusted odds ratios (aOR) with 95% confidence intervals (CI), to investigate maternal and intrapartum factors associated with neonatal admission or mortality.
Results: The incidence of neonatal admission or mortality following birth in an AMU was 1.2%, comprising neonatal admission (1.2%) and mortality (0.01%). White ‘other’ ethnicity (aOR=1.28; CI=1.01-1.63); nulliparity (aOR=2.09; CI=1.78-2.45); ≥2 previous pregnancies ≥24 weeks’ gestation (aOR=1.38; CI=1.10-1.74); male sex (aOR=1.46; CI=1.23-1.75); maternal pregnancy problem (aOR=1.40; CI=1.03-1.90); prolonged (aOR=1.42; CI=1.01-2.01) or unrecorded (aOR=1.38; CI=1.05-1.81) second stage duration; opiate use (aOR=1.31; CI=1.02-1.68); shoulder dystocia (aOR=5.06; CI=3.00-8.52); birthweight <2500g (aOR=4.12; CI=1.97-8.60), 4000-4999g (aOR=1.64; CI=1.25-2.14) and ≥4500g (aOR=2.10; CI=1.17-3.76), were independently associated with neonatal admission or mortality. Among babies admitted (n=1038), 18% received intensive care. Nine babies died, six following neonatal admission. Sepsis (52%) and respiratory distress (42%) were the most common discharge diagnoses.
Conclusions: The results of this study are in line with other evidence on risk factors for neonatal admission, and reassuring in terms of the quality and safety of care in AMUs.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
Actions
Access Document
- Files:
-
-
(Preview, Version of record, 377.4KB, Terms of use)
-
- Publisher copy:
- 10.1136/archdischild-2020-319099
Authors
- Publisher:
- BMJ Publishing Group
- Journal:
- Archives of Disease in Childhood More from this journal
- Volume:
- 106
- Issue:
- 2
- Pages:
- 194-203
- Publication date:
- 2020-09-30
- Acceptance date:
- 2020-08-21
- DOI:
- EISSN:
-
1468-2044
- ISSN:
-
0003-9888
- Language:
-
English
- Keywords:
- Pubs id:
-
1132481
- Local pid:
-
pubs:1132481
- Deposit date:
-
2020-09-16
Terms of use
- Copyright holder:
- Rowe et al.
- Copyright date:
- 2020
- Rights statement:
- © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
- Licence:
- CC Attribution (CC BY)
If you are the owner of this record, you can report an update to it here: Report update to this record