Citation

Gunnarsson B, Fasting S, Skogvoll E, Smárason AK, Salvesen KÅ. Acta Obstet. Gynecol. Scand. 2016; 96(3): 326-333.

Affiliation

Department of Obstetrics and Gynecology, St.Olav's University Hospital, Trondheim, Norway.

Copyright

(Copyright © 2016, John Wiley and Sons)

DOI

10.1111/aogs.13067

PMID

27886371

Abstract

INTRODUCTION: The aims were to describe causes of death associated with unplanned out-of-institution births, and to study if they could be prevented. MATERIAL AND METHODS: Retrospective population-based observational study based on data from the Medical Birth Registry of Norway and medical records. Between 1 January 1999 and 31 December 2013, 69 perinatal deaths among 6027 unplanned out-of-institution births, whether unplanned at home, during transportation, or unspecified, were selected for enquiry. Hospital records were investigated and cases classified according to Causes of Death and Associated Conditions.

RESULTS: 63 cases were reviewed. There were 25 (40%) antepartum deaths, 10 (16%) intrapartum, and 24 neonatal (38%) deaths. Four cases were in the unknown death category (6%). Both gestational age and birthweight followed a bimodal distribution with modes at 24 and 38 weeks and 750 and 3400 grams respectively. The most common main cause of death was infection (n=14, 22%), neonatal (n=14, 22%, thereof nine due to extreme prematurity) and placental (n=12, 19%, thereof seven placental abruptions). There were 86 associated conditions, most commonly perinatal (n=32), placental (n=15) and maternal (n=14). Further classification revealed that the largest subgroup was associated perinatal conditions / sub-optimal care, involving 25 cases (40%), most commonly due to sub-optimal maternal use of available care (n=14, 22%).

CONCLUSIONS: Infections, neonatal, and placental causes accounted for almost two-thirds of perinatal mortality associated with unplanned out-of-institution births in Norway. Sub-optimal maternal use of available care was found in more than one-fifth of cases. This article is protected by copyright. All rights reserved.

This article is protected by copyright. All rights reserved.

Language: en