The Library
24 hour consultant obstetrician presence on the labour ward and intrapartum outcomes in a large unit in England : a time series analysis
Tools
Morad, Sharon, Pitches, David, Girling, Alan, Taylor, Beck, Fradd, Vikki, MacArthur, Christine and Kenyon, Sara (2021) 24 hour consultant obstetrician presence on the labour ward and intrapartum outcomes in a large unit in England : a time series analysis. PLoS One, 16 (3). e0249233. e0249233. doi:10.1371/journal.pone.0249233 ISSN 1932-6203.
|
PDF
journal.pone.0249233.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (694Kb) | Preview |
Official URL: http://doi.org/10.1371/journal.pone.0249233
Abstract
Objectives
To explore the effect of introducing 24/7 resident labour ward consultant presence on neonatal and maternal outcomes in a large obstetric unit in England.
Design
Retrospective time sequence analysis of routinely collected data.
Setting
Obstetric unit of large teaching hospital in England.
Participants
Women and babies delivered between1 July 2011 and 30 June 2017. Births <24 weeks gestation or by planned caesarean section were excluded.
Main outcome measures
The primary composite outcome comprised intrapartum stillbirth, neonatal death, babies requiring therapeutic hypothermia, or admission to neonatal intensive care within three hours of birth. Secondary outcomes included markers of neonatal and maternal morbidity. Planned subgroup analyses investigated gestation (<34 weeks; 34–36 weeks; ≥37 weeks) and time of day.
Results
17324 babies delivered before and 16110 after 24/7 consultant presence. The prevalence of the primary outcome increased by 0.65%, from 2.07% (359/17324) before 24/7 consultant presence to 2.72% (438/16110, P < 0.001) after 24/7 consultant presence which was consistent with an upward trend over time already well established before 24/7 consultant presence began (OR 1.09 p.a.; CI 1.04 to 1.13). Overall, there was no change in this trend associated with the transition to 24/7. However, in babies born ≥37 weeks gestation, the upward trend was reversed after implementation of 24/7 (OR 0.67 p.a.; CI 0.49 to 0.93; P = 0.017). No substantial differences were shown in other outcomes or subgroups.
Conclusions
Overall, resident consultant obstetrician presence 24/7 on labour ward was not associated with a change in a pre-existing trend of increasing adverse infant outcomes. However, 24/7 presence was associated with a reversal in increasing adverse outcomes for term babies.
Item Type: | Journal Article | ||||||
---|---|---|---|---|---|---|---|
Subjects: | R Medicine > RG Gynecology and obstetrics | ||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||
Library of Congress Subject Headings (LCSH): | Maternal health services , Postnatal care, Obstetrics, Obstetricians , Obstetrical emergencies , Labor (Obstetrics) -- Complications, Pregnancy -- Complications | ||||||
Journal or Publication Title: | PLoS One | ||||||
Publisher: | Public Library of Science | ||||||
ISSN: | 1932-6203 | ||||||
Official Date: | 31 March 2021 | ||||||
Dates: |
|
||||||
Volume: | 16 | ||||||
Number: | 3 | ||||||
Page Range: | e0249233 | ||||||
Article Number: | e0249233 | ||||||
DOI: | 10.1371/journal.pone.0249233 | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||
Date of first compliant deposit: | 22 May 2023 | ||||||
Date of first compliant Open Access: | 24 May 2023 | ||||||
RIOXX Funder/Project Grant: |
|
Request changes or add full text files to a record
Repository staff actions (login required)
View Item |
Downloads
Downloads per month over past year