Royal Flying Doctor Service, Canberra, Australian Capital Territory, Australia.
The Rural Clinical School of Western Australia, The University of Western Australia, Albany, Western Australia, Australia.
Aust N Z J Obstet Gynaecol. 2021 Aug;61(4):519-527. doi: 10.1111/ajo.13308. Epub 2021 Jan 10.
Limited access to obstetrics and gynaecology (O&G) services in rural and remote Australia is believed to contribute to suboptimal birth outcomes.
To describe the characteristics of pregnancy aeromedical transfers, in-hospital outcomes, and patient access to O&G services, as compared to whole of Australia data.
We conducted a cohort study of women who required aeromedical retrieval for pregnancy-related issues between the 1 January 2015 and 31 December 2017.
Hospital outcome data were collected on 2171 (65.2%) mothers and 2438 (100.0%) babies. The leading retrieval reason was threatened preterm labour and delivery (n = 883; 40.7%). Most patients were retrieved from rural and remote areas (n = 2224; 93.0%). Retrieved patients were significantly younger (28.0 vs 30.0 years, 95% CI 27.7-28.3), more likely to be overweight or obese (52.2% vs 45.1%, 95% CI 47.5-56.9) and to have smoked during their pregnancy (14.0% vs 9.9%, 95% CI 12.5-15.5) compared to Australian pregnant women overall. Over one-third of transferred women gave birth by Caesarean section (n = 812; 37.4%); the median gestational age at birth was 33.0 (95% CI 32.7-33.3) weeks. Early gestation is associated with low birth weights (median = 2579.5 g; 95% CI 2536.1-2622.9), neonatal resuscitation (35.4%, 95% CI 33.5-37.3), and special care nursery admission (41.2%, 95% CI 39.3-43.2). There were 42 (1.7%, 95% CI 1.2-2.2) stillbirths, which was significantly higher than seen Australia-wide (n = 6441; 0.7%).
This study found that pregnant women retrieved by the Royal Flying Doctor Service were younger, with higher rates of obesity and smoking.
澳大利亚农村和偏远地区提供的妇产科服务有限，据信这会导致分娩结果不理想。
描述航空医疗转运妊娠患者的特征，以及与澳大利亚整体数据相比，这些患者在医院的结局和获得妇产科服务的情况。
我们对 2015 年 1 月 1 日至 2017 年 12 月 31 日期间因妊娠相关问题需要航空医疗救援的 2171 名母亲和 2438 名婴儿进行了队列研究。
收集到 2171 名（65.2%）母亲和 2438 名（100.0%）婴儿的医院结局数据。主要转运原因是早产和分娩威胁（n=883；40.7%）。大多数患者来自农村和偏远地区（n=2224；93.0%）。转运患者明显更年轻（28.0 岁与 30.0 岁，95%CI 27.7-28.3），更有可能超重或肥胖（52.2%与 45.1%，95%CI 47.5-56.9），且怀孕期间吸烟的比例更高（14.0%与 9.9%，95%CI 12.5-15.5）。与澳大利亚整体孕妇相比，转运患者的比例更高。超过三分之一的产妇行剖宫产分娩（n=812；37.4%）；中位分娩时孕周为 33.0（95%CI 32.7-33.3）周。早期妊娠与低出生体重（中位数=2579.5g；95%CI 2536.1-2622.9）、新生儿复苏（35.4%，95%CI 33.5-37.3）和新生儿特别护理病房入院（41.2%，95%CI 39.3-43.2）相关。有 42 例（1.7%，95%CI 1.2-2.2）死胎，明显高于澳大利亚整体水平（n=6441；0.7%）。
本研究发现，皇家飞行医生服务转运的孕妇更年轻，肥胖和吸烟的比例更高。
