Adverse outcomes of labour in public and private hospitals in Australia: A population-based descriptive study

Robson, SJ; Laws, P; Sullivan, EA

Adverse outcomes of labour in public and private hospitals in Australia: A population-based descriptive study

Robson, SJ Laws, P Sullivan, EA

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Publication Type:: Journal Article
Citation:: Medical Journal of Australia, 2009, 190 (9), pp. 474 - 477
Issue Date:: 2009-05-04

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Field	Value	Language
dc.contributor.author	Robson, SJ	en_US
dc.contributor.author	Laws, P	en_US
dc.contributor.author	Sullivan, EA https://orcid.org/0000-0002-8718-2753	en_US
dc.date.available	2008-12-10	en_US
dc.date.issued	2009-05-04	en_US
dc.identifier.citation	Medical Journal of Australia, 2009, 190 (9), pp. 474 - 477	en_US
dc.identifier.issn	0025-729X	en_US
dc.identifier.uri	http://hdl.handle.net/10453/28490
dc.description.abstract	Objective: To compare the rate of serious adverse perinatal outcomes of term labour between private and public maternity hospitals in Australia. Design, setting and participants: A population-based study of 789 240 term singleton births in public and private hospitals in 2001-2004, using data from the National Perinatal Data Collection. Main outcome measures: Third- and fourth-degree perineal injury, requirement for high level of neonatal resuscitation, Apgar score < 7 at 5 minutes, admission to neonatal intensive care unit or special care nursery, and perinatal death. Results: 31.4% of the term singleton births occurred in private hospitals. After adjusting for maternal age, Indigenous status, parity, smoking status, diabetes, hypertension, remoteness of usual residence, and method of birth, the rates of all adverse outcomes studied were higher for public hospital births. For women, the adjusted odds ratio (AOR) for third- or fourth-degree perineal injury was 2.28 (95% CI, 2.16-2.40). For babies, the odds of a high level of resuscitation (AOR, 2.37; 95% CI, 2.17-2.59), low Apgar score (AOR, 1.75; 95% CI, 1.65-1.84), intensive care requirement (AOR, 1.48; 95% CI, 1.45-1.51) and perinatal death (AOR, 2.02; 95% CI, 1.78-2.29) were all higher in public hospitals. Conclusion: For women delivering a single baby at term in Australia, the prevalence of adverse perinatal outcomes is higher in public hospitals than in private hospitals.	en_US
dc.relation.ispartof	Medical Journal of Australia	en_US
dc.subject.classification	General & Internal Medicine	en_US
dc.subject.mesh	Perineum	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Pregnancy Complications	en_US
dc.subject.mesh	Apgar Score	en_US
dc.subject.mesh	Pregnancy Outcome	en_US
dc.subject.mesh	Resuscitation	en_US
dc.subject.mesh	Infant Mortality	en_US
dc.subject.mesh	Risk Assessment	en_US
dc.subject.mesh	Pregnancy	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	Infant, Newborn	en_US
dc.subject.mesh	Hospitals, Private	en_US
dc.subject.mesh	Hospitals, Public	en_US
dc.subject.mesh	Australia	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Obstetric Labor Complications	en_US
dc.subject.mesh	Young Adult	en_US
dc.title	Adverse outcomes of labour in public and private hospitals in Australia: A population-based descriptive study	en_US
dc.type	Journal Article
utslib.citation.volume	9	en_US
utslib.citation.volume	190	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	11 Medical and Health Sciences	en_US
utslib.for	17 Psychology and Cognitive Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
utslib.copyright.status	closed_access
pubs.issue	9	en_US
pubs.publication-status	Published	en_US
pubs.volume	190	en_US

Abstract:

Objective: To compare the rate of serious adverse perinatal outcomes of term labour between private and public maternity hospitals in Australia. Design, setting and participants: A population-based study of 789 240 term singleton births in public and private hospitals in 2001-2004, using data from the National Perinatal Data Collection. Main outcome measures: Third- and fourth-degree perineal injury, requirement for high level of neonatal resuscitation, Apgar score < 7 at 5 minutes, admission to neonatal intensive care unit or special care nursery, and perinatal death. Results: 31.4% of the term singleton births occurred in private hospitals. After adjusting for maternal age, Indigenous status, parity, smoking status, diabetes, hypertension, remoteness of usual residence, and method of birth, the rates of all adverse outcomes studied were higher for public hospital births. For women, the adjusted odds ratio (AOR) for third- or fourth-degree perineal injury was 2.28 (95% CI, 2.16-2.40). For babies, the odds of a high level of resuscitation (AOR, 2.37; 95% CI, 2.17-2.59), low Apgar score (AOR, 1.75; 95% CI, 1.65-1.84), intensive care requirement (AOR, 1.48; 95% CI, 1.45-1.51) and perinatal death (AOR, 2.02; 95% CI, 1.78-2.29) were all higher in public hospitals. Conclusion: For women delivering a single baby at term in Australia, the prevalence of adverse perinatal outcomes is higher in public hospitals than in private hospitals.

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http://hdl.handle.net/10453/28490