Abstract
Background
Evidence suggests the closure of maternity units is associated with an increase in
babies born before arrival (BBA).
Aim
To explore the association between the number of maternity units in Australia and
Queensland by birthing numbers, BBA rate and geographic remoteness of the health district
where the mother lives.
Methods
A retrospective study utilised routinely collected perinatal data (1992–2011). Pearson
correlation tested the relationship between BBA rate and number of maternity units.
Linear regression examined this association over time.
Findings
During 1992–2011, the absolute numbers (N = 22,814) of women having a BBA each year in Australia increased by 47% (N = 836–1233); and 206% (n = 140–429) in Queensland. This coincided with a 41% reduction in maternity units in
Australia (N = 623–368 = 18 per year) and a 28% reduction in Queensland (n = 129–93). BBA rates increased significantly across Australia, r = 0.837, n = 20 years, p < 0.001 and Queensland, r = 0.917, n = 20 years, p < 0.001 and this was negatively correlated with the number of maternity units in Australia,
r = −0.804, n = 19 years, p < 0.001 and Queensland, r = −0.906, n = 19 years, p < 0.001.
Conclusions
The closure of maternity units over a 20-year period across Australia and Queensland
is significantly associated with increased BBA rates. The distribution is not limited
to rural and remote areas. Given the high risk of adverse maternal and neonatal outcomes
associated with BBA, it is time to revisit the closure of units.
Keywords
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Article Info
Publication History
Published online: April 03, 2015
Accepted:
March 14,
2015
Received in revised form:
March 12,
2015
Received:
December 24,
2014
Identification
Copyright
© 2015 Australian College of Midwives. Published by Elsevier Inc. All rights reserved.
