Maternal and neonatal outcomes of hospital vaginal deliveries in Tibet.
BACKGROUND
To determine the outcomes of vaginal deliveries in three study hospitals in Lhasa, Tibet Autonomous Region (TAR), People's Republic of China (PRC), at high altitude (3650 m).


METHODS
Prospective observational study of 1121 vaginal deliveries.


RESULTS
Pre-eclampsia/gestational hypertension (PE/GH) was the most common maternal complication 18.9% (n=212), followed by postpartum hemorrhage (blood loss > or = 500 ml) 13.4%. There were no maternal deaths. Neonatal complications included: low birth weight (10.2%), small for gestational age (13.7%), pre-term delivery (4.1%) and low Apgar (3.7%). There were 11 stillbirths (9.8/1000 live births) and 19 early neonatal deaths (17/1000 live births).


CONCLUSIONS
This is the largest study of maternal and newborn outcomes in Tibet. It provides information on the outcomes of institutional vaginal births among women delivering infants at high altitude. There was a higher incidence of PE/GH and low birth weight; rates of PPH were not increased compared to those at lower altitudes.
Miller
S
S
Women's Global Health Imperative, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, CA, USA. suellenmiller@gmail.com
Tudor
C
C
Nyima
Thorsten
V R
VR
Sonam
Droyoung
Craig
S
S
Le
P
P
Wright
L L
LL
Varner
M W
MW
D000328:Adult; D000531:Altitude; D036861:Delivery, Obstetric; D005260:Female; D005865:Gestational Age; D006760:Hospitalization; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008297:Male; D007744:Obstetric Labor Complications / Q000453:epidemiology* / Q000208:ethnology; D036801:Parturition; D011225:Pre-Eclampsia / Q000453:epidemiology / Q000208:ethnology; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000208:ethnology*; D050497:Stillbirth / Q000453:epidemiology / Q000208:ethnology; D018609:Tibet / Q000453:epidemiology