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Title: Are birth outcomes in low risk birth cohorts related to hospital birth volumes? : a systematic review
Author(s): Walther, Felix Steffen Herbert HansLook up in the Integrated Authority File of the German National Library
Kuester, Denise
Bieber, Anja MarthaLook up in the Integrated Authority File of the German National Library
Malzahn, JürgenLook up in the Integrated Authority File of the German National Library
Rüdiger, MarioLook up in the Integrated Authority File of the German National Library
Schmitt, Jochen
Issue Date: 2021
Type: Article
Language: English
Abstract: Background: There is convincing evidence that birth in hospitals with high birth volumes increases the chance of healthy survival in high-risk infants. However, it is unclear whether this is true also for low risk infants. The aim of this systematic review was to analyze effects of hospital’s birth volume on mortality, mode of delivery, readmissions, complications and subsequent developmental delays in all births or predefined low risk birth cohorts. The search strategy included EMBASE and Medline supplemented by citing and cited literature of included studies and expert panel highlighting additional literature, published between January/2000 and February/2020. We included studies which were published in English or German language reporting effects of birth volumes on mortality in term or all births in countries with neonatal mortality < 5/1000. We undertook a double-independent title-abstract- and full-text screening and extraction of study characteristics, critical appraisal and outcomes in a qualitative evidence synthesis. Results: 13 retrospective studies with mostly acceptable quality were included. Heterogeneous volume-thresholds, risk adjustments, outcomes and populations hindered a meta-analysis. Qualitatively, four of six studies reported significantly higher perinatal mortality in lower birth volume hospitals. Volume-outcome effects on neonatal mortality (n = 7), stillbirths (n = 3), maternal mortality (n = 1), caesarean sections (n = 2), maternal (n = 1) and neonatal complications (n = 1) were inconclusive. Conclusion: Analyzed studies indicate higher rates of perinatal mortality for low risk birth in hospitals with low birth volumes. Due to heterogeneity of studies, data synthesis was complicated and a meta-analysis was not possible. Therefore international core outcome sets should be defined and implemented in perinatal registries.
Open Access: Open access publication
License: (CC BY 4.0) Creative Commons Attribution 4.0(CC BY 4.0) Creative Commons Attribution 4.0
Journal Title: BMC pregnancy and childbirth
Publisher: BioMed Central
Publisher Place: London
Volume: 21
Original Publication: 10.1186/s12884-021-03988-y
Page Start: 1
Page End: 16
Appears in Collections:Open Access Publikationen der MLU

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