title: How safe is antenatal transfer between level 3 units?
abstract: 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 1991-194, 20 (59%) were delivered at the receiving centre, the remained 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 week, 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 side effect of social factors on transferred families.
authors.affiliation: Department of Paediatrics, Christchurch Hospital, New Zealand.
authors.forename: T J
authors.initials: TJ
authors.lastname: Malpas
authors.forename: J
authors.initials: J
authors.lastname: Meates
authors.forename: J
authors.initials: J
authors.lastname: Horwood
authors.forename: B A
authors.initials: BA
authors.lastname: Darlow
mesh_terms: D001724:Birth Weight; D001925:Brain Damage, Chronic / Q000401:mortality*; D002543:Cerebral Hemorrhage / Q000401:mortality; D002552:Cerebral Ventricles; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000401:mortality*; D015931:Intensive Care, Neonatal / Q000706:statistics & numerical data*; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D010360:Patient Transfer / Q000706:statistics & numerical data*; D011247:Pregnancy; D012127:Respiratory Distress Syndrome, Newborn / Q000401:mortality; D012178:Retinopathy of Prematurity / Q000401:mortality; D012306:Risk; D016019:Survival Analysis; D016896:Treatment Outcome