Neonatal neurological outcome after low-risk pregnancies.
OBJECTIVE
To study neonatal neurological outcome and obstetrical interventions in a low-risk population.


METHODS
A prospective non-randomised study.


METHODS
Six midwife practices, nine general practices in and around the city of Nijmegen, The Netherlands, and the obstetrical service at the Nijmegen University Hospital.


METHODS
766 midwife/general practitioner deliveries and 268 deliveries guided by obstetricians using electronic fetal monitoring, all after low risk pregnancy (one out of three selected), 49.2% of the women delivered at home.


METHODS
Neurological examination of the fullterm newborn infant according to Prechtl (1977).


RESULTS
The deliveries directed by the obstetricians showed higher complication and intervention rates for primiparae and multiparae. Primiparous deliveries involved longer labor and firstborns showed lower neurological outcome. There were no differences in neonatal neurological outcome between groups attended by midwives, general practitioners or obstetricians despite the lower social profile of the hospital group.


CONCLUSIONS
For the outcome of low-risk pregnancy, the place of birth in the Nijmegen area is irrelevant. Further investigations on the physiology of the first pregnancy and on the causes of the higher complication and intervention rates in hospital deliveries are recommended.
Berghs
G
G
Department of Obstetrics and Gynaecology, Catholic University, Nijmegen, The Netherlands.
Spanjaards
E
E
Driessen
L
L
Doesburg
W
W
Eskes
T
T
D005194:Family Practice; D005260:Female; D006700:Home Childbirth; D006761:Hospitals; D006801:Humans; D007231:Infant, Newborn; D008880:Midwifery; D009422:Nervous System Diseases / Q000453:epidemiology*; D009426:Netherlands / Q000453:epidemiology; D009460:Neurologic Examination; D007744:Obstetric Labor Complications / Q000453:epidemiology*; D009774:Obstetrics; D011247:Pregnancy; D011446:Prospective Studies; D012307:Risk Factors