Results from the Neonatal Admission Study

Published on Tuesday, 20 October 2020

Neonatal admission and mortality in babies born in UK alongside midwifery units: a national population-based case-control study using the UK Midwifery Study System (UKMidSS)

Many of the 'risk factors' for neonatal admission or mortality in babies born in alongside midwifery units are known risk factors for adverse neonatal outcome in term infants born in other settings.

A new UKMidSS study, published in Archives of Disease in Childhood: Fetal & Neonatal, funded by the National Institute for Health Research (NIHR) and led by Dr Rachel Rowe, has shown that the incidence of neonatal admission, or mortality, following birth in an AMU was 1.2% and 0.01% respectively. The most common reasons for admission to a neonatal unit were suspected infection (52%) and respiratory problems (42%). Women with pregnancy complications, such as raised BMI (>35kg/m2) or GBS colonisation, were 1.4 times more likely to have their baby admitted to a neonatal unit, compared with women without these complications. Other factors associated with neonatal admission or mortality in these babies were male sex, nulliparity or multiparity ≥2, prolonged or unrecorded second stage of labour, opioid use for pain relief, low birthweight (<2500g) and high birthweight (>4000g), and shoulder dystocia. Nine babies died, six following neonatal admission, and relatively few babies had diagnoses of suspected asphyxia or meconium aspiration.

The results of this study are reassuring and in line with existing evidence about the quality and safety of care in alongside midwifery units. Midwives should continue to practice in line with national guidance in relation to the management of risk factors and emerging complications in women labouring in AMUs.