Abstract:
OBJECTIVE:To compare intrapartum and neonatal mortality in low-risk term women starting labour in midwife-led versus obstetrician-led care. STUDY DESIGN:We performed a propensity score matched study using data from our national perinatal register, completed with data from medical files. We studied women without major risk factors with singleton pregnancies who gave birth at term between 2005 and 2008 in the Amsterdam region of the Netherlands. Major risk factors comprised non-vertex position of the fetus, previous Caesarean birth, hypertension, (gestational) diabetes mellitus, post-term pregnancy (≥42 weeks), prolonged rupture of membranes (>24 hours), vaginal bleeding in the second half of pregnancy or induced labour. Groups were devided by midwife-led versus obstetrician-led care at the onset of labour. The primary outcome was intrapartum and neonatal (<28 days) mortality. Secondary outcomes included obstetric interventions, 5 min Apgar scores<7 and neonatal intensive care admittance for >24 hours. RESULTS:We studied 57 396 women. Perinatal mortality occurred in 30 of 46 764 (0.64‰) women in midwife-led care and in 2 of 10 632 (0.19‰) women in obstetrician-led care (OR 3.4, 95% CI 0.82 to 14.3). A propensity score matched analysis in a 1:1 ratio with 10 632 women per group revealed an OR for perinatal mortality of 4.0 (95% CI 0.85 to 18.9). CONCLUSION:Among low-risk women, midwife-led care at the onset of labour was associated with a statistically non-significant higher mortality rate.
journal_name
BMJ Openjournal_title
BMJ openauthors
Wiegerinck MMJ,van der Goes BY,Ravelli ACJ,van der Post JAM,Buist FCD,Tamminga P,Mol BWdoi
10.1136/bmjopen-2017-018845subject
Has Abstractpub_date
2018-01-05 00:00:00pages
e018845issue
1issn
2044-6055pii
bmjopen-2017-018845journal_volume
8pub_type
杂志文章相关文献
BMJ Open文献大全abstract:OBJECTIVES:The use of psychoactive prescription medication is increasing in the general population. This is a cause for concern, particularly among the elderly, where physiological changes related to senescence increase the risk for adverse effects. While previous studies regarding psychoactive substance use have gener...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-032572
更新日期:2020-09-17 00:00:00
abstract:INTRODUCTION:Cryptococcal meningitis is responsible for around 15% of all HIV-related deaths globally. Conventional treatment courses with amphotericin B require prolonged hospitalisation and are associated with multiple toxicities and poor outcomes. A phase II study has shown that a single high dose of liposomal ampho...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmjopen-2018-026288
更新日期:2019-04-01 00:00:00
abstract:INTRODUCTION:Stroke is a major health problem and transient ischaemic attack (TIA) is an important risk factor for stroke. Primary prevention of stroke and TIA will have the greatest impact on reducing the burden of these conditions. Evidence-based guidelines for stroke/TIA prevention identify individuals eligible for ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2014-006622
更新日期:2014-11-11 00:00:00
abstract:CONTEXT:The Food and Drug Administration Modernization Act of 1997 (FDAMA) and the FDA Amendment Act of 2007 (FDAAA), respectively, established mandates for registration of interventional human research studies on the website clinicaltrials.gov (CTG) and for posting of results of completed studies. OBJECTIVE:To charac...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-001186
更新日期:2012-08-29 00:00:00
abstract:OBJECTIVES:To assess how the quality of metronome-guided cardiopulmonary resuscitation (CPR) was affected by the chest compression rate familiarised by training before the performance and to determine a possible mechanism for any effect shown. DESIGN:Prospective crossover trial of a simulated, one-person, chest-compre...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2015-010873
更新日期:2016-02-12 00:00:00
abstract:INTRODUCTION:Asthma-related morbidity and mortality in the UK is higher than elsewhere in Europe. Although the reasons for this are largely unclear, one explanation could be a higher prevalence of poorly controlled asthma in the UK. Findings from our earlier study found that, in a sample of 766 children with asthma, 45...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-025867
更新日期:2019-04-23 00:00:00
abstract:INTRODUCTION:Prescription-drug use in the USA has increased by more than 60% in the last three decades. Prevalence of prescription-drug use among pregnant women is currently estimated around 50%. Prevalence of illicit drug use in the USA is 14.6% among pregnant adolescents, 8.6% among pregnant young adults and 3.2% amo...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2017-020248
更新日期:2018-02-17 00:00:00
abstract:OBJECTIVE:In recent years, quality of life (QoL) in multiple sclerosis (MS) has been gaining considerable importance in clinical research and practice. Against this backdrop, this systematic review aimed to provide a broad overview of clinical, sociodemographic and psychosocial risk and protective factors for QoL in ad...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-041249
更新日期:2020-11-30 00:00:00
abstract:OBJECTIVE:To examine patterns of, and decision-making processes, informing referrals for inpatient access to integrative medicine (IM) services at a large, acute care hospital. DESIGN:Retrospective electronic health record review and structured qualitative interviews. SETTING:A 630-bed tertiary care hospital with an ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-012006
更新日期:2016-07-25 00:00:00
abstract:OBJECTIVES:Domestic violence screening is advocated in some healthcare settings. Evidence that it increases referral to support agencies or improves health outcomes is limited. This study aimed to (1) investigate the proportion of hospital patients reporting domestic violence, (2) describe characteristics and previous ...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2015-009069
更新日期:2016-01-04 00:00:00
abstract:OBJECTIVES:To estimate the present value of current and future funding needed for HIV treatment and prevention in 9 sub-Saharan African (SSA) countries that account for 70% of HIV burden in Africa under different scenarios of intervention scale-up. To analyse the gaps between current expenditures and funding obligation...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2015-009656
更新日期:2016-03-06 00:00:00
abstract:INTRODUCTION:An increasing number of patients survive sepsis; however, we lack valid data on the long-term impact on morbidity from prospective observational studies. Therefore, we designed an observational cohort to quantify mid-term and long-term functional disabilities after intensive care unit (ICU)-treated sepsis....
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2017-016827
更新日期:2017-08-23 00:00:00
abstract:OBJECTIVES:To develop an optimised 1:1 physiotherapy intervention that reflects best practice, with flexibility to tailor management to individual patients, thereby ensuring patient-centred practice. DESIGN:Mixed-methods combining evidence synthesis, expert review and focus groups. SETTING:Secondary care involving 5 ...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2015-009409
更新日期:2016-02-25 00:00:00
abstract:OBJECTIVE:To measure poverty-based disparities in inpatient length of stay for paediatric hospitalisations. In particular, this paper examines the relationship between municipality level poverty rates and length of stay, accounting for individual level characteristics. DESIGN:We use patient discharge data to conduct a...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-034512
更新日期:2020-08-16 00:00:00
abstract:INTRODUCTION:A large proportion of children and adolescents participate in organised sport, making community sports clubs a promising setting to support healthy behaviours. To date, however, there have been few interventions conducted in junior sports clubs that have targeted health-promoting practices. The primary aim...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2017-018906
更新日期:2018-01-23 00:00:00
abstract:INTRODUCTION:Surgery is one of the primary treatments for lung cancer. The postoperative symptom burden experienced by patients with lung cancer is substantial, seriously delaying their recovery from surgery and impairing their quality of life. Patient-reported outcome (PRO)-based symptom management is increasingly reg...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-030041
更新日期:2019-08-26 00:00:00
abstract:INTRODUCTION:Chronic obstructive pulmonary disease (COPD) exacerbations progress the course of disease and impair lung function. Inhaled maintenance therapy reduces exacerbations. It is not yet established which inhaled therapy combination is best to reduce exacerbations, lung function decline and symptom burden. METH...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-025048
更新日期:2019-02-20 00:00:00
abstract:INTRODUCTION:Despite the significant disease burden of bronchiectasis in Korea, no large-scale, representative prospective cohort studies have been conducted to evaluate the clinical characteristics of Korean patients with bronchiectasis, indicating an urgent need for cohort studies on bronchiectasis. METHODS AND ANAL...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-034090
更新日期:2020-01-19 00:00:00
abstract:OBJECTIVES:Endometriosis is a gynaecological disease most commonly causing severe and chronic pelvic pain as well as an impaired quality of life. The aim of this study was to investigate if and how endometriosis affects choices regarding professional life as well as the quality of daily working life. DESIGN, SETTING A...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2017-019570
更新日期:2019-01-09 00:00:00
abstract:INTRODUCTION:Cardiovascular disease (CVD) and cancer are leading causes of death globally. Early detection of cancer and risk factors for CVD may improve health outcomes and reduce mortality. General practitioners (GPs) are accessed by the majority of the population and play a key role in the prevention and early detec...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2012-001405
更新日期:2012-07-02 00:00:00
abstract:OBJECTIVES:Many sedentary individuals are aware of the health benefits of regular physical activity and start becoming more physically active. Yet, despite good intentions, many struggle to keep up initial exercise levels and experience a decline in exercise frequency. A possible explanation is that it is hard to estab...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-024043
更新日期:2019-02-13 00:00:00
abstract:OBJECTIVES:'Horizontal inequity' in healthcare finance occurs when people with equal income contribute unequally to healthcare payments. Prior research is lacking on horizontal inequity in China. Accordingly, this study set out to examine horizontal inequity in the Chinese healthcare financing system in 2002 and 2007 t...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-025184
更新日期:2019-01-09 00:00:00
abstract:OBJECTIVES:Understanding patients' preferences for treatment is crucial to provision of good care and shared decisions, especially when more than one treatment option exists for a given condition. One such condition is infection of the area around the prosthesis after hip replacement, which affects between 0.4% and 3% ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-031645
更新日期:2020-01-21 00:00:00
abstract:OBJECTIVES:The study aimed to understand through qualitative research what patients considered material in their decision to consent to an acute surgical intervention. PARTICIPANTS, SETTING AND INTERVENTION:The patients selected aged between 18 and 90, having been admitted to a major trauma centre to undergo an acute ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2020-037657
更新日期:2020-10-08 00:00:00
abstract:OBJECTIVES:To investigate different professionals' (nurse anaesthetists', anaesthesiologists', and postanaesthesia care unit nurses') descriptions of and reflections on the postoperative handover. DESIGN:A focus group interview study with a descriptive design using qualitative content analysis of transcripts. SETTING...
journal_title:BMJ open
pub_type: 杂志文章,多中心研究
doi:10.1136/bmjopen-2016-015038
更新日期:2017-08-04 00:00:00
abstract:INTRODUCTION:Patients with chronic obstructive pulmonary disease (COPD) often have multiple hospitalisations because of exacerbation. Evidence shows disease management programmes are one of the most cost-effective measures to prevent re-hospitalisation for COPD exacerbation, but lack implementation and economic apprais...
journal_title:BMJ open
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmjopen-2015-009988
更新日期:2016-06-15 00:00:00
abstract:OBJECTIVE:Evidence-based clinical resources (EBCRs) have the potential to improve diagnostic and therapeutic accuracy. The majority of US teaching medical institutions have incorporated them into clinical training. Many EBCRs are subscription based, and their cost is prohibitive for most clinicians and trainees in low-...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2018-026947
更新日期:2019-08-08 00:00:00
abstract:OBJECTIVE:The diagnosis of transient ischaemic attack (TIA) based on symptoms and signs can be challenging and would greatly benefit from a rapid serum biomarker of brain ischaemia. We aimed to quantify the added diagnostic value of serum biomarkers in patients suspected of TIA beyond symptoms and signs. METHODS:This ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2019-031774
更新日期:2019-10-17 00:00:00
abstract:BACKGROUND:In recent years, there has been increased interest in the use of ultrasound technology in the evaluation of spinal and paraspinal regions. OBJECTIVE:This study aimed to investigate trends in spinal ultrasound research from 1994 to 2015 and compare the contributions of such research from different countries ...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2016-015317
更新日期:2017-10-22 00:00:00
abstract:OBJECTIVES:CT colonography (CTC) may be an acceptable test for colorectal cancer screening but bowel preparation can be a barrier to uptake. This study tested the hypothesis that prospective screening invitees would prefer full-laxative preparation with higher sensitivity and specificity for polyps, despite greater bur...
journal_title:BMJ open
pub_type: 杂志文章
doi:10.1136/bmjopen-2013-004327
更新日期:2014-04-03 00:00:00