Monk Amy R, Grigg Celia P, Foureur Maralyn, Tracy Mark, Tracy Sally K
F,aculty of Health, the University of Technology Sydney, PO Box 222, Ultimo, 2007 NSW, Australia.
School of Health Sciences, Division of Midwifery, Floor 12, Tower Block, Park Campus, University of Nottingham, Nottingham NG7 2RD, England, UK.
Midwifery. 2017 Mar;46:24-28. doi: 10.1016/j.midw.2017.01.006. Epub 2017 Jan 10.
the viability of freestanding midwifery units in Australia is restricted, due to concerns over their safety, particularly for women and babies who, require transfer.
to compare the maternal and neonatal birth outcomes of women who planned, to give birth at freestanding midwifery units and subsequently, transferred to a tertiary maternity unit to the maternal and neonatal, outcomes of a low-risk cohort of women who planned to give birth in, tertiary maternity unit.
a descriptive study compared two groups of women with low-risk singleton, pregnancies who were less than 28 weeks pregnant at booking: women who, planned to give birth at a freestanding midwifery unit (n=494) who, transferred to a tertiary maternity unit during the antenatal, intrapartum or postnatal periods (n=260) and women who planned to give, birth at a tertiary maternity unit (n=3157). Primary outcomes were mode, of birth, Apgar score of less than 7 at 5minutes and admission to, special care nursery or neonatal intensive care.
the proportion of women who experienced a caesarean section was lower, among the freestanding midwifery unit women who transferred during the, intrapartum/postnatal period compared to women in the tertiary maternity, unit group (16.1% versus 24.8% respectively). Other outcomes were, comparable between the cohorts. Rates of primary outcomes in relation to, stage of transfer varied when stratified by parity.
these descriptive results support the provision of care in freestanding, midwifery units as an alternative to tertiary maternity units for women, with low risk pregnancies at the time of booking. A larger study, powered, to determine statistical significance of any differences in outcomes, is, required.
由于对独立助产机构安全性的担忧，尤其是对于那些需要转诊的妇女和婴儿，澳大利亚独立助产机构的生存能力受到限制。
比较计划在独立助产机构分娩，随后转诊至三级产科单位的妇女的母婴分娩结局，与计划在三级产科单位分娩的低风险队列妇女的母婴结局。
一项描述性研究比较了两组在孕早期（孕周小于28周）单胎低风险妊娠的妇女：计划在独立助产机构分娩（n = 494），并在产前、产时或产后转诊至三级产科单位的妇女（n = 260），以及计划在三级产科单位分娩的妇女（n = 3157）。主要结局指标为分娩方式、5分钟时阿氏评分低于7分以及入住特殊护理病房或新生儿重症监护病房。
在产时/产后转诊的独立助产机构组妇女中，剖宫产的比例低于三级产科单位组的妇女（分别为16.1%和24.8%）。其他结局在两组之间具有可比性。按产次分层时，与转诊阶段相关的主要结局发生率有所不同。
这些描述性结果支持为孕早期低风险妊娠的妇女提供独立助产机构护理，作为三级产科单位护理的替代方案。需要开展一项更大规模的研究，以确定结局差异的统计学显著性。
