1. Hastane dışı doğumlar: Bir olgu-kontrol çalışması.
- Author
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Diana, Lima, Glaucia, Lima, Adriana, Cersosimo, and Israel, Figueiredo Jr
- Subjects
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LOW birth weight , *CHI-squared test , *CHILDBIRTH , *CONFIDENCE intervals , *DELIVERY (Obstetrics) , *DISEASES , *FISHER exact test , *LENGTH of stay in hospitals , *INFANT mortality , *MATHEMATICAL statistics , *MOTHER-child relationship , *MATERNAL mortality , *NEONATAL intensive care , *NONPARAMETRIC statistics , *SCIENTIFIC observation , *PRENATAL care , *PROBABILITY theory , *T-test (Statistics) , *LOGISTIC regression analysis , *PARAMETERS (Statistics) , *QUANTITATIVE research , *NEONATAL intensive care units , *RETROSPECTIVE studies , *CASE-control method , *ODDS ratio , *MANN Whitney U Test ,PREGNANCY complication risk factors - Abstract
Aim: To identify the factors, risks, and mortality associated with unplanned out-of-hospital births. Material and Methods: This observational, retrospective, case-control study was conducted between 2005 and 2013 through a review of medical records from the hospital network of a county of Brazil. Mother-child dyads were divided into in-hospital births and unplanned out-of-hospital births. For hypothesis testing involving quantitative variables, parametric and nonparametric methods (t-test or Mann-Whitney test, respectively) were used as appropriate after ascertaining normality of distribution via the Kolmogorov-Smirnov or Shapiro-Wilk tests. The chi-square test, Fisher's exact test, odds ratios, and 95% confidence intervals were used to assess the relationship between categorical variables. A binary logistic regression was applied for pooled analysis of those variables that, when analyzed in isolation, had significant p-values on hypothesis testing. In all tests, p-values <0.05 were considered statistically significant. Results: Of the 420 records, 117 corresponded to out-of-hospital births dyads. Mothers were predominantly nonwhite (p<0.001), with a history of inadequate antenatal care (p<0.001), multiparous (p<0.001), aged >25 years (p=0.031), and had more puerperal complications (p<0.001). Their newborns had low birth weight (Odds Ratios: 2.22; 95% CI: [1.4-3.4]; p<0.001), higher morbidity (p=0.009), a higher rate of admission to neonatal intensive care and stepdown units (p=0.030), and prolonged length of stay (p<0.001). Conclusion: The risk of maternal and neonatal complications, as well as the neonatal mortality rate, were higher for unplanned outof- hospital deliveries. It occurred predominantly in nonwhite, older, multiparous women who had received incomplete antenatal care and who lived far from perinatal care centers. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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