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dc.contributor.authorEngjom, Hilde Marieeng
dc.contributor.authorMorken, Nils-Halvdaneng
dc.contributor.authorNorheim, Ole Frithjofeng
dc.contributor.authorKlungsøyr, Karieng
dc.date.accessioned2014-12-09T16:49:28Z
dc.date.available2014-12-09T16:49:28Z
dc.date.issued2014eng
dc.identifier.issn1470-0328eng
dc.identifier.urihttp://hdl.handle.net/1956/8866
dc.description.abstract<p>Objective: To assess the availability of obstetric institutions, the risk of unplanned delivery outside an institution and maternal morbidity in a national setting in which the number of institutions declined from 95 to 51 during 30 years.</p><p>Design: Retrospective population-based, three cohorts and two cross-sectional analyses.</p><p>Setting: Census data, Statistics Norway. The Medical Birth Registry of Norway from 1979 to 2009.</p><p>Population: Women (15–49 years), 2000 (n=1 050 269) and 2010 (n=1 127 665). Women who delivered during the period 1979–2009 (n=1 807 714).</p> <p>Methods: Geographic Information Systems software for travel zone calculations. Cross-table and multiple logistic regression analysis of change over time and regional differences. World Health Organization Emergency Obstetric and Newborn Care (EmOC) indicators.</p><p>Main outcome measures: Proportion of women living outside the 1-hour travel zone to obstetric institutions. Risk of unplanned delivery outside obstetric institutions. Maternal morbidity.</p><p>Results: The proportion of women living outside the 1-hour zone for all obstetric institutions increased from 7.9% to 8.8% from 2000 to 2010 (relative risk, 1.1; 95% confidence interval, 1.11– 1.12), and for emergency obstetric care from 11.0% to 12.1% (relative risk, 1.1; 95% confidence interval, 1.09–1.11). The risk of unplanned delivery outside institutions increased from 0.4% in 1979–83 to 0.7% in 2004–09 (adjusted odds ratio, 2.0; 95% confidence interval, 1.9–2.2). Maternal morbidity increased from 1.7% in 2000 to 2.2% in 2009 (adjusted odds ratio, 1.4; 95% confidence interval, 1.2–1.5) and the regional differences increased.</p><p>Conclusions: The availability of and access to obstetric institutions was reduced and we did not observe the expected decrease in maternal morbidity following the centralisation.</p>en_US
dc.language.isoengeng
dc.publisherJohn Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologistseng
dc.relation.ispartof<a href="http://hdl.handle.net/1956/21286" target="blank">Obstetric care in Norway - the role of institution availability and place of delivery for maternal and perinatal outcomes. Population-based retrospective cohort studies</a>
dc.rightsAttribution-NonCommercial-NoDerivs CC BY-NC-NDeng
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/eng
dc.titleAvailability and access in modern obstetric care: a retrospective population-based studyeng
dc.typeJournal articleeng
dc.subject.nsiVDP::Medisinske fag: 700::Klinisk medisinske fag: 750::Gynekologi og obstetrikk: 756nob
dc.subject.nsiVDP::Medical sciences: 700::Clinical medical sciences: 750::Gynaecology and obstetrics: 756eng
dc.date.updated2014-12-08T13:27:54Zen_US
dc.rights.holderCopyright 2013 The Authors
dc.type.versionpublishedVersioneng
bora.peerreviewedPeer reviewedeng
bora.journalTitleBJOG: An International Journal of Obstetrics & Gynaecologyeng
bibo.volume121eng
bibo.issue3eng
bibo.pageStart290eng
bibo.pageEnd299eng
bibo.doihttp://dx.doi.org/10.1111/1471-0528.12510eng
bora.accessRightsinfo:eu-repo/semantics/openAccesseng
dc.identifier.cristinID1126705eng
dc.identifier.doi10.1111/1471-0528.12510
dc.source.issn1470-0328en_US
bora.bpoaIDbpoa9


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