Maternal morbidity and pregnancy outcome in a cohort of mothers transferred out of perinatal centres during a national census.
OBJECTIVE
To record the maternal morbidity and pregnancy outcome in this cohort.


METHODS
Retrospective data collection from a prospectively defined cohort.


METHODS
The 37 largest perinatal centres in the UK.


METHODS
258 in utero transfers recorded during a three-month census (1/4/99-30/6/99).


METHODS
A questionnaire regarding the outcome of each mother was sent to the perinatal centre and receiving hospital.


RESULTS
Data were returned on 242/258 (94%) mothers. Fifty-eight percent were transferred out of their perinatal centre in preterm labour and 38% had coexisting disease necessitating early delivery. The median gestational age at transfer was 32 weeks (range 23-41). Sixty-one percent delivered at the receiving hospital; 12% were transferred on to a third hospital and 29% ultimately returned to deliver at the original perinatal centre. Fifty-two percent of mothers received postnatal care in hospitals other than those defined as a major perinatal centre. One mother delivered during transfer and a further nine within one hour of arrival. One mother received intensive care after delivery and later died, a further 7% required high dependency care postnatally. Data were available on 273/333 (82%) babies. The median gestational age at delivery was 34 weeks (range 24-41). Six infants were stillborn and 187/264 (71%) infants were admitted to a neonatal unit.


CONCLUSIONS
This study has documented the maternal morbidity, potential risks and pregnancy outcome of a cohort of mothers transferred out of the largest perinatal centres in the UK because of a shortage of neonatal cots. A national standard for the delivery of high risk perinatal services is needed to uphold good clinical practice guidelines in the care of high risk mothers and their infants.
Bennett
Charlotte C
CC
John Radcliffe Hospital, Oxford, UK.
Lal
Mithilesh K
MK
Field
David J
DJ
Wilkinson
Andrew R
AR
D001509:Bed Occupancy / Q000706:statistics & numerical data; D015331:Cohort Studies; D036861:Delivery, Obstetric; D005260:Female; D005865:Gestational Age; D006801:Humans; D015931:Intensive Care, Neonatal / Q000706:statistics & numerical data; D007752:Obstetric Labor, Premature / Q000401:mortality*; D010360:Patient Transfer / Q000706:statistics & numerical data; D011247:Pregnancy; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D011446:Prospective Studies; D012111:Residence Characteristics; D012189:Retrospective Studies; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology