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Background: Regional analgesia is a common and effective form of in‐labour analgesia. However, there are concerns whether it is associated with adverse maternal and neonatal outcomes. Aims: To examine the association between regional analgesia and maternal and neonatal outcomes. Materials and Methods: A retrospective population‐based cohort study of singleton term births in Victoria, Australia, between 2014 and 2020. Women who received regional analgesia were compared with women who did not. Multivariable logistic and linear regressions were used. Results: There were 107 013 women who received regional analgesia and 214 416 women who did not. Compared to women who did not receive regional analgesia, regional analgesia was associated with an increased risk of instrumental birth (adjusted odds ratio (aOR) = 3.59, 95% CI: 3.52–3.67), caesarean section (aOR = 2.30, 95% CI: 2.24–2.35), longer duration of the second stage of labour (β coefficient = 26.6 min, 95% CI: 26.3–27.0), Apgar score below seven at five minutes (aOR = 1.30, 95% CI: 1.21–1.39), need for neonatal resuscitation (aOR = 1.44, 95% CI: 1.40–1.48), need for formula in hospital (aOR = 1.68, 95% CI: 1.65–1.72), and the last feed before discharge not exclusively from the breast (aOR = 1.59, 95% CI: 1.56–1.62). Conclusion: Regional analgesia use in labour was associated with adverse maternal and neonatal outcomes. These findings may add to the risk–benefit discussion regarding regional analgesia for pain relief and highlight the importance of shared decision‐making. Further large prospective studies and randomised controlled trials will be useful. [ABSTRACT FROM AUTHOR]

Background: The high maternal and neonatal mortality rate in sub‐Saharan Africa could be reduced by using navigation by means of mobile devices to increase the number of women who choose to give birth in a health center (HC) with a skilled healthcare practitioner. Methods: A quasi‐experimental design was used to test a midwife‐delivered navigation by means of mobile phone. A total of 208 women were randomized to two groups (intervention and control). Women in the intervention group received up to three navigation calls from midwives. Women in the control group received usual antenatal education during prenatal visits. Data were collected using semistructured questionnaires. Childbirth location was determined through medical records. Results: Overall, 180 (87%) women gave birth in a HC with a 3% advantage for the intervention group. A total of 86% (88/102) of the control group gave birth in a HC versus 89% (92/103) for the intervention group (Χ2 = 0.44, p‐value = 0.51), with an unadjusted odds ratio of 1.33 (95% CI: 0.57, 3.09). Among those with personal phones, 91% (138/152) had a birth in a HC versus 79% (42/53) in those without a personal phone (Χ2 = 4.89, p‐value = 0.03). Conclusions: The results of this study indicate that it is feasible to deliver phone‐based navigation to support birth in a HC; personal phone ownership may be a factor in the success of this strategy. [ABSTRACT FROM AUTHOR]

Background: External cephalic version (ECV) should be offered for patients presenting with a noncephalic pregnancy that are willing to deliver vaginally. Various reports have evaluated predictors for successful ECV. Yet, none have reported a single‐operator large cohort experience. We aim to analyze the outcome of referrals for ECV. Methods: We conducted a retrospective cohort study of prospectively collected data. We performed a multivariate analysis of data with respect to ECV procedures performed by a single operator in a 6‐year period. Maternal and fetal characteristics were compared between ECV success and failure groups. Results: Six hundred and two women underwent ECV. Of them, ECV was successful in 432 (71.7%). A multivariate binary logistic regression model demonstrated that high liquor volume was a predictor of ECV success (Adj OR 1.17 [95% CI 1.09‐1.26]). Failure of ECV was correlated with anterior placenta (0.44 [0.56‐0.76]) and nulliparity (0.21 [0.11‐0.36]). Adverse events were rare and mostly minor, occurring in 1% of procedures. Conclusions: ECV has a high success rate and a low complication rate, enabling vaginal birth and avoiding cesarean. The role of manipulation of modifiable determinants such as liquor volume should be further assessed in future studies. [ABSTRACT FROM AUTHOR]

Objective To determine the risk factors associated with having a very low birth weight ( VLBW) infant as a follow-up to the first phase of a Perinatal Periods of Risk approach. Design and Sample Retrospective cohort analysis of birth certificates. Population-based sample of 53,427 birth certificates for the city under study during the years 1999-2006. Measures The relationship of selected maternal characteristics as predictors of VLBW using multivariate logistic regression analysis. Results The maternal characteristics associated with VLBW were as follows: no prenatal care (OR = 4.04), inadequate weight gain (OR = 3.97), Black, non-Hispanic race (OR = 1.50), less than 20 years old (OR = 1.42) and more than 35 years old (OR = 1.43). After analyzing age and race/ethnicity together, Black non-Hispanic women less than 20 years of age (OR = 2.70) or over 35 years of age (OR = 2.45) still had an increased odds for having a VLBW infant whereas Black non-Hispanic women between the ages of 20 and 35 did not. Conclusions The findings of this study suggest educating women on the importance of preconception care, prenatal care, and adequate pregnancy weight gain to reduce the odds of having a VLBW infant. [ABSTRACT FROM AUTHOR]