Evidence map›Paper›PMID 24848087›Full record

ArticleBMJ open2014

Rates of obstetric intervention and associated perinatal mortality and morbidity among low-risk women giving birth in private and public hospitals in NSW (2000-2008): a linked data population-based cohort study.

Hannah G Dahlen, Sally Tracy, Mark Tracy, Andrew Bisits, Chris Brown, Charlene Thornton

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Article in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  16. Factors promoting or inhibiting normal birth.BMC pregnancy and childbirth · 2018
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Hannah G DahlenFamily and Community Health Research Group, School of Nursing and Midwifery, University of Western Sydney, Penrith, New South Wales, Australia.
Sally TracyRoyal Hospital for Women, University of Sydney, Sydney, Australia.
Mark TracyCentre for Newborn Care, Westmead Hospital, Westmead, New South Wales, Australia School of Medicine, University of Sydney, Camperdown, New South Wales, Australia.
Andrew BisitsRoyal Hospital for Women, Randwick, New South Wales, Australia School of Women and Children's Health, University of NSW, Randwick, New South Wales, Australia.
Chris BrownNHMRC Clinical Trials Centre, University of Sydney, Camperdown, New South Wales, Australia.
Charlene ThorntonFamily and Community Health Research Group, School of Nursing and Midwifery, University of Western Sydney, Penrith, New South Wales, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo examine the rates of obstetric intervention and associated perinatal mortality and morbidity in the first 28 days among low-risk women giving birth in private and public hospitals in NSW (2000-2008).

designLinked data population-based retrospective cohort study involving five data sets.

settingNew South Wales, Australia.

participants691 738 women giving birth to a singleton baby during the period 2000-2008.

main outcome measuresRates of neonatal resuscitation, perinatal mortality, neonatal admission following birth and readmission to hospital in the first 28 days of life in public and private obstetric units.

resultsRates of obstetric intervention among low-risk women were higher in private hospitals, with primiparous women 20% less likely to have a normal vaginal birth compared to the public sector. Neonates born in private hospitals were more likely to be less than 40 weeks; more likely to have some form of resuscitation; less likely to have an Apgar <7 at 5 min. Neonates born in private hospitals to low-risk mothers were more likely to have a morbidity attached to the birth admission and to be readmitted to hospital in the first 28 days for birth trauma (5% vs 3.6%); hypoxia (1.7% vs 1.2%); jaundice (4.8% vs 3%); feeding difficulties (4% vs 2.4%) ; sleep/behavioural issues (0.2% vs 0.1%); respiratory conditions (1.2% vs 0.8%) and circumcision (5.6 vs 0.3%) but they were less likely to be admitted for prophylactic antibiotics (0.2% vs 0.6%) and for socioeconomic circumstances (0.1% vs 0.7%). Rates of perinatal mortality were not statistically different between the two groups.

conclusionsFor low-risk women, care in a private hospital, which includes higher rates of intervention, appears to be associated with higher rates of morbidity seen in the neonate and no evidence of a reduction in perinatal mortality.

Indexed as

Hospitals, PrivateHospitals, PublicPerinatal MortalityAdultCohort StudiesDelivery, ObstetricFemaleHumansInfant, NewbornInfant, Newborn, DiseasesInformation Storage and RetrievalMaleNew South WalesPregnancyRetrospective StudiesRiskNeonatologyObstetrics

Identifiers

PMID24848087
PMCPMC4039844

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.