Antenatal transfer of rural women to perinatal centres. High Risk Obstetric and Perinatal Advisory Working Group.
The aim of this study was to describe antenatal transfers of rural women to perinatal centres, and among transferred women, to assess the use of selected evidence-based therapies and determine the predictors of preterm and imminent births. The clinical records of rural women antenatally transferred to perinatal centres in NSW and the ACT during 1997-1998 were reviewed. Of 453 rural antenatal transfers, 408 (90%) were emergency transfers. Increasing remoteness was associated with increased rates of antenatal transfer but not with a lower probability of giving birth. Of all transferred women, 64% delivered; 58% of preterm transfers delivered preterm and of those delivering preterm, 76% delivered within 7 days. Although the main reason for antenatal transfer was the possibility of preterm birth, women presenting with preterm contractions only were less likely to deliver preterm (OR = 0.2, 95% CI 0.1-0.4) or < or = 7 days (OR = 0.3, 95% CI 0.2-0.5) than women with any other presenting symptoms. The overall usage of effective interventions (antenatal steroids, antibiotics for PPROM and beta-mimetic tocolysis to delay birth) among antenatally transferred rural women was high, but there is room for increased uptake prior to transfer.
Roberts
C L
CL
NSW Centre for Perinatal Health Services Research, Department of Obstetrics and Gynaecology, University of Sydney, Australia.
Henderson-Smart
D
D
Ellwood
D A
DA
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D004630:Emergencies; D019317:Evidence-Based Medicine; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000209:etiology / Q000628:therapy*; D006302:Health Services Research; D006801:Humans; D008507:Medically Underserved Area; D009517:New South Wales / Q000453:epidemiology; D007752:Obstetric Labor, Premature / Q000209:etiology / Q000628:therapy*; D010360:Patient Transfer / Q000706:statistics & numerical data*; D010500:Perinatology / Q000379:methods* / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000628:therapy*; D011256:Pregnancy Outcome / Q000453:epidemiology; D018566:Pregnancy, High-Risk; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D013256:Steroids; D015149:Tocolytic Agents / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D013256:Steroids; D015149:Tocolytic Agents