Characteristics and in-hospital outcomes of patients requiring aeromedical retrieval for pregnancy, compared to non-retrieved metropolitan cohorts

Fergus W. Gardiner, Alice Richardson, Carly Roxburgh, Marianne Gillam, Leonid Churilov, Ruth McCuaig, Sean Carter, Christopher Arthur, Cynthia Wong, Adam Morton, Leonie Callaway, Karin Lust, Sarah J. Davidson, Katie Foxcroft, Kiri Oates, Lucy Zhang, Sahani Jayawardane, Mathew Coleman, Michael Peek

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Limited access to obstetrics and gynaecology (O&G) services in rural and remote Australia is believed to contribute to suboptimal birth outcomes. Aims: 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. Materials and methods: We conducted a cohort study of women who required aeromedical retrieval for pregnancy-related issues between the 1 January 2015 and 31 December 2017. Results: 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%). Conclusion: This study found that pregnant women retrieved by the Royal Flying Doctor Service were younger, with higher rates of obesity and smoking.

Original languageEnglish
JournalAustralian and New Zealand Journal of Obstetrics and Gynaecology
DOIs
Publication statusE-pub ahead of print - 10 Jan 2021

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