Kildea Sue, McGhie Alexandra C, Gao Yu, Rumbold Alice, Rolfe Margaret
Midwifery Research Unit, Mater Research Institute, The University of Queensland, Mater Health Services, Level 1, Aubigny Place, Raymond Terrace, South Brisbane, Qld 4101, Australia; School of Nursing and Midwifery, The University of Queensland, Qld 4101, Australia.
Midwifery Research Unit, Mater Research Institute, Australian Catholic University, 1100 Nudgee Road, Banyo, Qld 4014, Australia.
Women Birth. 2015 Sep;28(3):236-45. doi: 10.1016/j.wombi.2015.03.003. Epub 2015 Apr 4.
Evidence suggests the closure of maternity units is associated with an increase in babies born before arrival (BBA).
To explore the association between the number of maternity units in Australia and Queensland by birthing numbers, BBA rate and geographic remoteness of the health district where the mother lives.
A retrospective study utilised routinely collected perinatal data (1992-2011). Pearson correlation tested the relationship between BBA rate and number of maternity units. Linear regression examined this association over time.
During 1992-2011, the absolute numbers (N=22,814) of women having a BBA each year in Australia increased by 47% (N=836-1233); and 206% (n=140-429) in Queensland. This coincided with a 41% reduction in maternity units in Australia (N=623-368=18 per year) and a 28% reduction in Queensland (n=129-93). BBA rates increased significantly across Australia, r=0.837, n=20 years, p<0.001 and Queensland, r=0.917, n=20 years, p<0.001 and this was negatively correlated with the number of maternity units in Australia, r=-0.804, n=19 years, p<0.001 and Queensland, r=-0.906, n=19 years, p<0.001.
The closure of maternity units over a 20-year period across Australia and Queensland is significantly associated with increased BBA rates. The distribution is not limited to rural and remote areas. Given the high risk of adverse maternal and neonatal outcomes associated with BBA, it is time to revisit the closure of units.
有证据表明，产科病房关闭与产前出生婴儿数量增加有关。
通过分娩数量、产前出生婴儿率以及母亲居住的健康区的地理偏远程度，探讨澳大利亚和昆士兰州产科病房数量之间的关联。
一项回顾性研究利用了常规收集的围产期数据（1992 - 2011年）。皮尔逊相关性检验了产前出生婴儿率与产科病房数量之间的关系。线性回归分析了这一关联随时间的变化情况。
在1992 - 2011年期间，澳大利亚每年产前出生婴儿的绝对数量（N = 22,814）增加了47%（从N = 836增加到1233）；昆士兰州增加了206%（从n = 140增加到429）。这与澳大利亚产科病房数量减少41%（从N = 623减少到368，即每年减少18个）以及昆士兰州产科病房数量减少28%（从n = 129减少到93）相吻合。澳大利亚的产前出生婴儿率显著上升，r = 0.837，n = 20年，p < 0.001；昆士兰州的产前出生婴儿率也显著上升，r = 0.917，n = 20年，p < 0.001，并且这与澳大利亚产科病房数量呈负相关，r = -0.804，n = 19年，p < 0.001；与昆士兰州产科病房数量也呈负相关，r = -0.906，n = 19年，p < 0.001。
在20年时间里，澳大利亚和昆士兰州产科病房的关闭与产前出生婴儿率的增加显著相关。这种分布并不局限于农村和偏远地区。鉴于产前出生婴儿与孕产妇和新生儿不良结局的高风险相关，现在是时候重新审视产科病房的关闭问题了。
