How Safe is Antenatal Transfer Between Level 3 Units?

Authors

  • Timothy J. Malpas J MRCP,

    Corresponding author
    1. Departments of Paediatrics, Christchurch Hospital, Christchurch Women's Hospital and Christchurch School of Medicine, Christchurch, New Zealand
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  • Jeremy Meates MB, ChB,

    1. Departments of Obstetrics and Gynaecology, Christchurch Hospital, Christchurch Women's Hospital and Christchurch School of Medicine, Christchurch, New Zealand
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  • John Horwood ‘ MSc, BA,

    1. Departments of Psychological Medicine Christchurch Hospital, Christchurch Women's Hospital and Christchurch School of Medicine, Christchurch, New Zealand
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  • Brian A. DarlowJ MD FRACP

    1. Departments of Paediatrics, Christchurch Hospital, Christchurch Women's Hospital and Christchurch School of Medicine, Christchurch, New Zealand
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5 Department of Paediatrics, Christchurch Hospital, Private Bag, Christchurch, New Zealand.

Abstract

Summary: The effect of antenatal transport of women between level 3 units in New Zealand on maternal and infant well-being was examined in a retrospective case-controlled study. The outcomes of women transferred to other level 3 centres because of lack of neonatal unit space were compared with women who were able to be delivered at Christchurch Women's Hospital (CWH). Of 34 women transferred out of CWH from 1991–1994, 20 (59%) were delivered at the receiving centre, the remainder returning undelivered. Women transferred from Christchurch were more likely to be of lower parity (p<0.05), and were less likely to be in premature labour than those who remained in Christchurch (p<0.05). There was a trend for the initial risk of mortality as assessed by the Clinical Risk Index for Babies (CRIB) score to be lower for those infants born out of Christchurch but this was not statistically significant. Mortality, oxygen requirement at 36 weeks, periventricular haemorrhage, retinopathy of prematurity, and the time to regain birth-weight were not statistically different between the 2 groups, despite significantly more outborn children being male (p<0.05). Antenatal transfer therefore seems to be a safe procedure, although this study did not consider the potentially serious effect of social factors on transferred families.

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