Intrapartum and neonatal mortality in low risk term women in midwife ‐led care and obstetrician‐led care at the onset of labour: a national matched cohort study

AbstractIntroductionMidwife ‐led models of care have been subject of debate for many years. We conducted a study to compare intrapartum and neonatal mortality rates in midwife‐led (primary) versus obstetrician‐led (secondary) care at the onset of labour in low risk term women.Material and methodsWe performed an unmatched and a propensity score matched cohort study using data from the national perinatal audit registry (PAN) and from the national perinatal registry (PERINED) of the Netherlands. We included women with singleton pregnancies (without congenital anomalies or antepartum fetal death) who gave birth at term between 2010 and 2012. We excluded the following major risk factors: non ‐vertex position of the fetus, previous cesarean birth, hypertension, diabetes mellitus, prolonged rupture of membranes (≥ 24 hours), vaginal bleeding in the second half of pregnancy, non‐spontaneous start of labour and post term pregnancy (≥42 weeks). The primary outcome was intrapartum or neonatal mortality up to 28 days after birth. Secondary outcome measures were mode of delivery and a 5‐minute Apgar score below 7.ResultsWe included 259 211 women. There were 100/206 642 (0.48 ‰) intrapartum and neonatal deaths in the midwife group and 23/52 569 (0.44‰) in the obstetrician group (OR 1.11 (95% CI 0.70 to 1.74)). Propensity score matched analysis showed mortality rates of 0.49‰ (26/52 569) among women in midwife‐led care and 0.44‰ (23/52 569) fo...
Source: Acta Obstetricia et Gynecologica Scandinavica - Category: OBGYN Authors: Tags: ORIGINAL RESEARCH ARTICLE Source Type: research

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AbstractIntroductionMidwife ‐led models of care have been subject of debate for many years. We conducted a study to compare intrapartum and neonatal mortality rates in midwife‐led (primary) versus obstetrician‐led (secondary) care at the onset of labour in low risk term women.Material and methodsWe performed an unmatched and a propensity score matched cohort study using data from the national perinatal audit registry (PAN) and from the national perinatal registry (PERINED) of the Netherlands. We included women with singleton pregnancies (without congenital anomalies or antepartum fetal death) who gave birth at term b...
Source: Acta Obstetricia et Gynecologica Scandinavica - Category: OBGYN Authors: Tags: ORIGINAL RESEARCH ARTICLE Source Type: research
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