Evidence map›Paper›PMID 38684256›Full record

ArticleBMJ open2024

Inequalities in birth before arrival at hospital in South West England: a multimethods study of neonatal hypothermia and emergency medical services call-handler advice.

Laura Goodwin, Kim Kirby, Graham McClelland, Emily Beach, Adam Bedson, Jonathan Richard Benger, Toity Deave, Ria Osborne, Helen McAdam, Roisin McKeon-Carter and 3 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.7field-weighted citation impact, top 16% of its field
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

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Review
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

13 authors at 6 institutions in 1 country.

Laura GoodwinSchool of Health and Social Wellbeing, University of the West of England, Bristol, UK.ORCID 0000-0002-9118-4620
Kim KirbySchool of Health and Social Wellbeing, University of the West of England, Bristol, UK kim.kirby@uwe.ac.uk.ORCID 0000-0002-8092-7978
Graham McClellandNorthumbria University, Newcastle upon Tyne, UK.
Emily BeachSchool of Health and Social Wellbeing, University of the West of England, Bristol, UK.
Adam BedsonSouth Western Ambulance Service NHS Foundation Trust, Exeter, UK.
Jonathan Richard BengerSchool of Health and Social Wellbeing, University of the West of England, Bristol, UK.
Toity DeaveCentre for Child and Adolescent Health, University of the West of England, Bristol, UK.
Ria OsborneResearch, Audit & Improvement, South Western Ambulance Service NHS Foundation Trust, Exeter, UK.
Helen McAdamHealth Sciences and Wellbeing, University of Sunderland, Sunderland, UK.
Roisin McKeon-CarterUniversity Hospitals Plymouth NHS Trust, Plymouth, UK.
Nick MillerSchool of Health and Social Wellbeing, University of the West of England, Bristol, UK.
Hazel TaylorResearch Design Service, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
Sarah VossSchool of Health and Social Wellbeing, University of the West of England, Bristol, UK.ORCID 0000-0001-5044-5145
University of the West of England · GBSouth Western Ambulance Service NHS Foundation Trust · GBNorthumbria University · GBUniversity Hospitals Bristol NHS Foundation Trust · GBUniversity Hospitals Plymouth NHS Trust · GBUniversity of Sunderland · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo examine inequalities in birth before arrival (BBA) at hospitals in South West England, understand which groups are most likely to experience BBA and how this relates to hypothermia and outcomes (phase A). To investigate opportunities to improve temperature management advice given by emergency medical services (EMS) call-handlers during emergency calls regarding BBA in the UK (phase B).

designA two-phase multimethod study. Phase A analysed anonymised data from hospital neonatal records between January 2018 and January 2021. Phase B analysed anonymised EMS call transcripts, followed by focus groups with National Health Service (NHS) staff and patients.

settingSix Hospital Trusts in South West England and two EMS providers (ambulance services) in South West and North East England.

participants18 multidisciplinary NHS staff and 22 members of the public who had experienced BBA in the UK.

results35% (64/184) of babies conveyed to hospital were hypothermic on arrival. When compared with national data on all births in the South West, we found higher percentages of women with documented safeguarding concerns at booking, previous live births and 'late bookers' (booking their pregnancy >13 weeks gestation). These women may, therefore, be more likely to experience BBA. Preterm babies, babies to first-time mothers and babies born to mothers with disability or safeguarding concerns at booking were more likely to be hypothermic following BBA. Five main themes emerged from qualitative data on call-handler advice: (1) importance placed on neonatal temperature; (2) advice on where the baby should be placed following birth; (3) advice on how to keep the baby warm; (4) timing of temperature management advice and (5) clarity and priority of instructions.

conclusionsFindings identified factors associated with BBA and neonatal hypothermia following BBA. Improvements to EMS call-handler advice could reduce the number of babies arriving at hospital hypothermic.

Indexed as

Emergency Medical ServicesHypothermiaAdultEnglandFemaleFocus GroupsHumansInfant, NewbornMalePregnancyaccident & emergency medicinehealth equitymaternal medicineneonatologypaediatric A&E and ambulatory care

Identifiers

PMID38684256
PMCPMC11057285
OpenAlexW4396223274

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.