Table 4.
Labour outcomes in caseload midwifery compared to women with similar distance from their local antenatal clinic to maternity unit
| All deliveries = 3915 | Caseload Midwifery n = 2679% (n) | Similar distance standard care n = 1236% (n) | Crude OR (95% CI) | Adj. ORa (95% CI) |
|---|---|---|---|---|
| Elective Cesarean Section = 341 | 8.4 (225) | 9.4 (116) | 0.89 (0.70;1.12) | 0.89 (0.69;1.16) |
| Planned vaginal birth n = 3574 | ||||
| Birth< 32 weeks | 0.7 (17) | 1.0 (11) | 0.70 (0.33;1.51) | 0.63 (0.28;1.43) |
| Births< 37 weeks | 6.9 (168) | 7.3 (82) | 0.93 (0.70;1.23) | 0.95 (0.68;1.32) |
| Induction | 26.0 (639) | 26.2 (293) | 1.07 (0.88;1.30) | 1.04 (0.85;1.28) |
| Cervix ≤4 cm at arrival | 70.1 (520) | 70.6 (293) | 0.98 (0.75;1.27) | 0.94 (0.71;1.26) |
| Augmentation (syntocinon) | 22.1 (542) | 17.9 (200) | 1.30 (1.09;1.56) | 1.28 (1.05;1.55) |
| Amniotomy | 21.5 (528) | 18.9 (212) | 1.17 (0.98;1.40) | 1.15 (0.95;1.39) |
| Epidural (vaginal birth) | 24.4 (599) | 23.6 (264) | 1.05 (0.88;1.24) | 1.01 (0.84;1.21) |
| Emergency CS | 16.5 (405) | 16.8 (188) | 0.98 (0.81;1.19) | 1.04 (0.84;1.28) |
| Instrumental delivery | 5.8 (142) | 5.9 (66) | 0.98 (0.73;1.32) | 1.05 (0.77;1.44) |
| Labour length ≤ 10 h | 72.8 (1704) | 69.0 (729) | 1.20 (1.02;1.41) | 1.30 (1.09;1.55) |
| No laceration | 65.8 (1615) | 67.0 (750) | 0.95 (0.82;1.11) | 1.02 (0.87;1.20) |
| Laceration 1 or 2 | 32.1 (788) | 31.3 (350) | 1.04 (0.89;1.21) | 0.97 (0.82;1.14) |
| Laceration 3 or 4 | 2.3 (57) | 1.9 (21) | 1.24 (0.75;2.07) | 1.21 (0.67;1.87) |
| Apgar≤7 at 1 min | 6.8 (167) | 4.9 (55) | 1.41 (1.03;1.93) | 1.43 (1.04;1.98) |
| Apgar≤7 at 5 min | 2.0 (48) | 1.1 (12) | 1.84 (0.97;3.48) | 2.00 (1.02;3.89) |
| Umb.ven.pH ≤ 7.05 | 0.5 (11) | 0.5 (6) | 0.84 (0.31;2.26) | 0.93 (0.34;2.52) |
| Umb.art.pH ≤ 7.05 | 1.6 (40) | 1.1 (12) | 1.53 (0.80;2.93) | 1.59 (0.81;3.15) |
| Transfer to NCU | 6.2 (151) | 5.9 (66) | 1.05 (0.78;1.41) | 1.00 (0.73;1.38) |
| Early discharge | 33.0 (809) | 31.1 (348) | 1.09 (0.94;1.27) | 1.05 (0.86;1.28) |
aAdjusted for maternal age, parity, maternal pre-pregnancy BMI, birth weight, smoking habits, need for interpreter, maternity unit, and birth year. We also controlled for pre-pregnancy risks which included: former IUGR, caesarean sections, and preterm births. And complications during pregnancy included: malformations; alcohol or drug abuse; IVF; primiparous < 20; preeclampsia; hypertension; diabetes; premature contractions < 37 weeks of gestation; vaginal bleeding < 37 weeks of gestation; placental abnormalities; uterine abnormalities, and blood type incompatibilities (Rh, ABO, platelets, hydrops foetalis, and other kinds of blood type incompatibilities)