Travel time from home to hospital and adverse perinatal outcomes

January 01, 0001

Travel time from home to hospital and adverse perinatal outcomes

These Dutch authors studied the effect of travel time, at the start or during labour, from home to hospital on mortality and adverse outcomes in pregnant women at term in primary and secondary care. They identified a population-based cohort study from 2000 up to and including 2006 from the Netherlands Perinatal Registry including 751,926 singleton term hospital births. They assessed the impact of travel time by car, calculated from the postal code of the woman’s residence to the 99 maternity units, on neonatal outcome.

They found: "The mortality was 1.5 per 1000 births, and adverse outcomes occurred in 6.0 per 1000 births. There was a positive relationship between longer travel time (more than 20 minutes) and total mortality (OR 1.17), neonatal mortality within 24 hours (OR 1.51, 95% CI 1.13-2.02) and with adverse outcomes (OR 1.27). In addition to travel time, both delivery at 37 weeks of gestation (OR 2.23) or 41 weeks of gestation (OR 1.52) increased the risk of mortality."

The authors concluded: "A travel time from home to hospital of 20 minutes or more by car is associated with an increased risk of mortality and adverse outcomes in women at term in the Netherlands. These findings should be considered in plans for the centralisation of obstetric care."

This large cohort demonstrates a small increase in risk of adverse perinatal outcomes for rural women in a developed country.

For the full abstract, click here.

BJOG 118(4):457-465, March 2011 © 2010 to the Royal College of Obstetricians and Gaenecologists
Travel time from home to hospital and adverse perinatal outcomes in women at term in the Netherlands. ACJ Ravelli, KJ Jager, MH de Groot, et al. Correspondence to Dr. Ravelli: [email protected]

Category: W. Pregnancy, Childbirth, Family Planning, HSR Health Services Research. Keywords: birth, perinatal mortality, rural health, cohort study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 15 March 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

COVID-19 Resources

WONCA webinars, journal links and more

WONCA position statements

WONCA statements on a variety of issues

PEARLS

577 Individual behavioural counselling helps people to quit smoking 575 Antioxidant vitamin and mineral supplements may be beneficial in age-related macular degeneration 574 Oral antifungals effective for toenail onychomycosis 570 Decision aids beneficial for people facing health treatment or screening decisions 569 Computer-generated reminders on paper benefit quality of care