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Why babies die in unplanned out-of-institution births: an enquiry into perinatal
deaths in Norway 1999-2013
#MMPMID27886371
Gunnarsson B
; Fasting S
; Skogvoll E
; Smárason AK
; Salvesen KĹ
Acta Obstet Gynecol Scand
2017[Mar]; 96
(3
): 326-333
PMID27886371
show ga
INTRODUCTION: The aims were to describe causes of death associated with unplanned
out-of-institution births, and to study whether they could be prevented. MATERIAL
AND METHODS: Retrospective population-based observational study based on data
from the Medical Birth Registry of Norway and medical records. Between 1 January
1999 and 31 December 2013, 69 perinatal deaths among 6027 unplanned
out-of-institution births, whether unplanned at home, during transportation, or
unspecified, were selected for enquiry. Hospital records were investigated and
cases classified according to Causes of Death and Associated Conditions. RESULTS:
63 cases were reviewed. There were 25 (40%) antepartum deaths, 10 (16%)
intrapartum deaths, and 24 neonatal (38%) deaths. Four cases were in the unknown
death category (6%). Both gestational age and birthweight followed a bimodal
distribution with modes at 24 and 38 weeks and 750 and 3400 g, respectively. The
most common main cause of death was infection (n = 14, 22%), neonatal (n = 14,
22%, nine due to extreme prematurity) and placental (n = 12, 19%, seven placental
abruptions). There were 86 associated conditions, most commonly perinatal (n =
32), placental (n = 15) and maternal (n = 14). Further classification revealed
that the largest subgroup was associated perinatal conditions/sub-optimal care,
involving 25 cases (40%), most commonly due to sub-optimal maternal use of
available care (n = 14, 22%). CONCLUSIONS: Infections, neonatal, and placental
causes accounted for almost two-thirds of perinatal mortality associated with
unplanned out-of-institution births in Norway. Sub-optimal maternal use of
available care was found in more than one-fifth of cases.
|*Cause of Death
[MESH]
|*Infant Mortality
[MESH]
|*Prenatal Care
[MESH]
|Adolescent
[MESH]
|Adult
[MESH]
|Female
[MESH]
|Gestational Age
[MESH]
|Home Childbirth/statistics & numerical data
[MESH]
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