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.
John Radcliffe Hospital, Oxford, UK.
Charlotte C
CC
Bennett
Mithilesh K
MK
Lal
David J
DJ
Field
Andrew R
AR
Wilkinson
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