G. Berghs et al., NEONATAL NEUROLOGICAL OUTCOME AFTER LOW-RISK PREGNANCIES, European journal of obstetrics, gynecology, and reproductive biology, 62(2), 1995, pp. 167-171
Objectives: To study neonatal neurological outcome and obstetrical int
erventions in a low-risk population. Study design: A prospective non-r
andomised study. Setting: Six midwife practices, nine general practice
s in and around the city of Nijmegen, The Netherlands, and the obstetr
ical service at the Nijmegen University Hospital. Subjects: 766 midwif
e/general practitioner deliveries and 268 deliveries guided by obstetr
icians using electronic fetal monitoring, all after low risk pregnancy
(one out of three selected), 49.2% of the women delivered at home. Me
thods: Neurological examination of the fullterm newborn infant accordi
ng to Prechtl (1977). Results: The deliveries directed by the obstetri
cians showed higher complication and intervention rates for primiparae
and multiparae. Primiparous deliveries involved longer labor and firs
tborns showed lower neurological outcome. There were no differences in
neonatal neurological outcome between groups attended by midwives, ge
neral practitioners or obstetricians despite the lower social profile
of the hospital group. Conclusion: For the outcome of low-risk pregnan
cy, the place of birth in the Nijmegen area is irrelevant. Further inv
estigations on the physiology of the first pregnancy and on the causes
of the higher complication and intervention rates in hospital deliver
ies are recommended.