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DOI	10.1016/j.puhe.2023.01.027
	More than time: travel time to the delivery ward and maternal outcomes-onset of labour, postpartum haemorrhage and obstetric anal sphincter injury
	Holowko, N.; Haas, J.; Ahlberg, M.; Stephansson, O.; Ortqvist, A.
通讯作者	Holowko, N
来源期刊	PUBLIC HEALTH
ISSN	0033-3506
EISSN	1476-5616
出版年	2023
卷号	217 页码:105-114
英文摘要	Background: Closing delivery units increases travel time for some women. Whether increased travel time is associated with maternal outcomes is important for understanding the consequences of such closures. Previous studies are limited in measuring travel time and restricted to the outcome of caesarean section. Methods: Our population-based cohort includes data from the Swedish Pregnancy Register for women giving birth between 2014 and 2017 (N = 364,630). We estimated travel time from home to the delivery ward using coordinate pairs of actual addresses. The association between travel time and onset of labour was modelled using multinomial logistic regression, and logistic regression was used for the outcomes postpartum haemorrhage (PPH) and obstetric anal sphincter injury (OASIS). Findings: Over three-quarters of women had <= 30 min travel time (median 13.9 min). Women who travelled >= 60 min arrived to care sooner and laboured there longer. Women with further to travel had increased adjusted odds ratio (aOR) of having an elective caesarean section (31-59 min aOR 1.11; 95% confidence interval [CI] 1.07-1.16; >= 60 min aOR 1.25; 95% CI 1.16-1.36) than spontaneous onset of la-bour. Women (at full term with spontaneous onset) living >= 60 min away had reduced odds of having a PPH (aOR 0.84; 95% CI 0.76-0.94) or OASIS (aOR 0.79; 95% CI 0.66-0.94). Interpretation: Longer travel time increased the odds of elective caesarean section. Women with furthest to travel arrived sooner and spent more time in care; although they had a lower risk of PPH or OASIS, they also tended to be younger, have a higher body mass index and were Nordic born.(c) 2023 The Author(s). Published by Elsevier Ltd on behalf of The Royal Society for Public Health.
英文关键词	Travel time Maternal outcomes Onset of labour Postpartum haemorrhage Obstetric anal sphincter injury (OASIS) Severe perineal tear
类型	Article
语种	英语
开放获取类型	hybrid, Green Published
收录类别	SCI-E ; SSCI
WOS记录号	WOS:000954880900001
WOS关键词	RISK-FACTORS
WOS类目	Public, Environmental & Occupational Health
WOS研究方向	Public, Environmental & Occupational Health
资源类型	期刊论文
条目标识符	http://119.78.100.177/qdio/handle/2XILL650/398184
推荐引用方式 GB/T 7714	Holowko, N.,Haas, J.,Ahlberg, M.,et al. More than time: travel time to the delivery ward and maternal outcomes-onset of labour, postpartum haemorrhage and obstetric anal sphincter injury[J],2023,217:105-114.
APA	Holowko, N.,Haas, J.,Ahlberg, M.,Stephansson, O.,&Ortqvist, A..(2023).More than time: travel time to the delivery ward and maternal outcomes-onset of labour, postpartum haemorrhage and obstetric anal sphincter injury.PUBLIC HEALTH,217,105-114.
MLA	Holowko, N.,et al."More than time: travel time to the delivery ward and maternal outcomes-onset of labour, postpartum haemorrhage and obstetric anal sphincter injury".PUBLIC HEALTH 217(2023):105-114.