Travel Time To maTerniTy uniTs and perinaTal adverse ouTcomes in Burgundy

Abstract

In Burgundy, 11 135 women who gave birth between 2000 and 2009 lived more than 30 minutes away from a maternity unit and 467 lived more than 45 minutes away. Our aim was to analyze the impact of travel time from home to the nearest maternity unit on perinatal health indicators. methods: Our study included the 139 196 singleton births between 2000 and 2009 to women living in Burgundy. The data were from the “extended” PMSI perinatal network of Burgundy. Road travel times were calculated using the post code of the mother’s home and the nearest maternity unit. The impact of travel time on health indicators was analyzed using multilevel regressions adjusted for individual data, the socio-demographic environment and rural residence. results: For travel times longer than 45 minutes, crude stillbirth rates increased from 0.46% to 0.86% and those for perinatal mortality from 0.64% to 1.07%. After adjustment, the risk of stillbirth, perinatal mortality, births outside hospital, fetal cardiac rhythm anomalies, meconium in the amniotic fluid, antenatal maternal hospitalization increased with journey time. discussion/conclusion: Our results show that in Burgundy, travel time to the nearest maternity unit has an impact on perinatal health. Other studies are needed because these consequences need to be taken into account in calculations concerning the expected economies of scale engendered by restructurations of maternity care.