An obstetric and neonatal study on unplanned deliveries before arrival at hospital

Abstract

Objective: To establish the prevalence of unplanned deliveries before arrival at a big metropolitan hospital and to determine the demographic characteristics of the group of women at risk of delivering before arrival.

Design: A random case control study. Each baby born before arrival and its mother were compared to the next baby born in the same Department.

Subjects: All babies born before arrival at the Department of Obstetrics and Gynecology, University "La Sapienza" in a 10 yr. period (Jan 1983-Dec 1993).

Results: Of 27,274 consecutive deliveries in the study period, 22 (0.8%) babies were born before arrival at hospital. Of the 22 women who delivered before arrival, 16 were Italian, 5 were considered nomad (no fixed address) and one was a Polish tourist. No statistical difference was found between groups regarding maternal age, parity, gestational age, birth weight and immediate delivery complications. No mortality cases were observed in the study or control group. Neonatal stay in the neonatal ward was longer in the study group (6.5 vs 3.5 days, P < 0.001). Hypothermia was the highest morbidity (P < 0.001) and neonatal complications were more prevalent in babies delivered before arrival than in-born babies (P < 0.001).

Conclusions: Delivery before arrival to hospital does not seem to carry a higher neonatal mortality risk. However, the prevalence of complications was higher in such babies, with hypothermia being the highest morbidity.