No fixed place of birth: Unplanned BBAs in Victoria, Australia
No fixed place of birth: Unplanned BBAs in Victoria, Australia
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DOI：
10.1016/j.midw.2011.12.002
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发表时间：
2013-02-01
期刊：
影响因子：
2.7
通讯作者：
Archer, Frank
中科院分区：
文献类型：
--
作者：
McLelland, Gayle;McKenna, Lisa;Archer, Frank
目的：主要目的是提供1991年至2008年间维多利亚州未计划生育发生率的数据。次要目标-提供广泛的文献综述，突出围绕计划外BBA的问题。设定：维多利亚州的BBAs发病率在相关政府报告中公布。设计：数据摘自维多利亚州公布的有关围产期统计数据的政府报告——澳大利亚健康与福利研究所和维多利亚州围产期数据收集单位。从两个来源确定并列出了每年出生地点的数据。对数据来源进行了比较，以便了解院外分娩的范围。结果：与总出生数相比，维多利亚州产前意外分娩（BBA）的发生率和绝对数量较低。然而，这一数字与具有类似卫生系统的其他发达国家的计划外BBAs相当。从1991年到2008年，计划外BBAs的发生率缓慢但稳定地翻了一番。这两个数据来源几乎是一致的，除了1999年外，当时报告的计划外脑卒中发生率存在无法解释的差异。与计划中的在家分娩或在医院分娩相比，计划外的bba分娩后的孕产妇和新生儿结局要差得多。多种母体因素可增加意外BBA的风险。关键结论：应采用多种方法来管理计划外BBAs。应进行产前筛查，以确定风险最大的妇女。可以制定战略，减少新生儿和孕产妇的不良后果，包括对妇女及其伴侣进行关于立即管理新生儿的教育；确保护理人员掌握最新的分娩护理知识；产科和救护车服务部门应制定管理计划，以照顾计划外的BBAs妇女。版权所有：爱思唯尔有限公司版权所有。
Objectives: the primary objective-to present data on the incidence of unplanned births before arrival (BBAs) in Victoria between 1991 and 2008. The secondary objective-to provide an extensive literature review highlighting the issues surrounding an unplanned BBA.Setting: the incidence of BBAs in Victoria published in the relevant government reports.Design: data were extracted from published government reports pertaining to perinatal statistics in Victoria-The Australian Institute of Health and Wellbeing and the Perinatal Data Collection Unit of Victoria. Data on place of birth for each year from both sources was identified and tabulated. Comparisons between the data sources were undertaken to provide a picture of the scope of out of hospital birth.Findings: the incidence and absolute numbers of unplanned birth before arrival (BBA) to hospital in Victoria, are low compared to the total births. However, this number is comparable to unplanned BBAs in other developed countries with similar health systems. The incidence of unplanned BBAs has slowly but steadily doubled since 1991-2008. The two data sources almost mirror each other except for 1999 when there was an unexplained difference in the reported incidence in unplanned BBAs. Maternal and neonatal outcomes are disproportionally much poorer after unplanned BBAs than either planned home births or in hospital births. Various maternal factors can increase the risk of an unplanned BBA.Key conclusions: multiple approaches should be adopted to manage unplanned BBAs. Antenatal screening should be undertaken to identify the women most at risk. Strategies can be developed that will reduce poor neonatal and maternal outcomes, including education for women and their partners on immediate management of the newborn; ensuring paramedics have current knowledge on care during childbirth; and maternity and ambulance services should develop management plans for care of women having unplanned BBAs. Copyright (c) 2011 Elsevier Ltd. All rights reserved.