Travel time and perinatal mortality after emergency caesarean sections: an evaluation of the 2-hour proximity indicator in Sierra Leone.
geographic information systems
maternal health
Journal
BMJ global health
ISSN: 2059-7908
Titre abrégé: BMJ Glob Health
Pays: England
ID NLM: 101685275
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
received:
09
09
2020
revised:
22
11
2020
accepted:
24
11
2020
entrez:
23
12
2020
pubmed:
24
12
2020
medline:
25
6
2021
Statut:
ppublish
Résumé
Longer travel times are associated with increased adverse maternal and perinatal outcomes. Geospatial modelling has been increasingly used to estimate geographic proximity in emergency obstetric care. In this study, we aimed to assess the correlation between modelled and patient-reported travel times and to evaluate its clinical relevance. Women who delivered by caesarean section in nine hospitals were followed up with home visits at 1 month and 1 year. Travel times between the location before the delivery and the facility where caesarean section was performed were estimated, based on two models (model I Ouma The median reported travel time was 60 min, compared with 13 and 34 min estimated by the two models, respectively. The 2-hour access threshold correlated with a patient-reported travel time of 5.7 hours for model I and 1.8 hours for model II. Longer travel times were associated with transport by boat and ambulance, visiting one or two facilities before reaching the final facility, lower education and poverty. Lower perinatal mortality was found both in the group with a reported travel time of 2 hours or less (193 vs 308 per 1000 births, p<0.001) and a modelled travel time of 2 hours or less (model I: 209 vs 344 per 1000 births, p=0.003; model II: 181 vs 319 per 1000 births, p<0.001). The standard model, used to estimate geographical proximity, consistently underestimated the travel time. However, the conservative travel time model corresponded better to patient-reported travel times. The 2-hour threshold as determined by the Lancet Commission on Global Surgery, is clinically relevant with respect to reducing perinatal death, not a clear cut-off.
Identifiants
pubmed: 33355267
pii: bmjgh-2020-003943
doi: 10.1136/bmjgh-2020-003943
pmc: PMC7754652
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Commentaires et corrections
Type : ErratumIn
Informations de copyright
© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
Psychophysiology. 2017 May;54(5):706-712
pubmed: 28139018
BMC Pregnancy Childbirth. 2017 Jul 25;17(1):242
pubmed: 28743257
Acta Paediatr. 2014 Dec;103(12):e522-7
pubmed: 25197024
Glob Health Sci Pract. 2017 Sep 28;5(3):430-445
pubmed: 28839113
Annu Rev Public Health. 2003;24:25-42
pubmed: 12668754
BJOG. 2011 Mar;118(4):457-65
pubmed: 21138515
Lancet Glob Health. 2018 Nov;6(11):e1196-e1252
pubmed: 30196093
Reprod Health Matters. 2015 May;23(45):149-50
pubmed: 26278843
Health Place. 2013 Nov;24:225-33
pubmed: 24177417
Anesth Analg. 2018 Apr;126(4):1329-1339
pubmed: 29547428
JAMA Surg. 2016 Nov 1;151(11):1064-1069
pubmed: 27580500
Br J Surg. 2019 Jan;106(2):e138-e150
pubmed: 30570764
Int J Health Geogr. 2012 Nov 15;11:49
pubmed: 23153311
Health Aff (Millwood). 2019 Sep;38(9):1576-1584
pubmed: 31479351
Int J Health Geogr. 2012 Sep 17;11:40
pubmed: 22984920
BMJ Glob Health. 2019 Sep 4;4(5):e001605
pubmed: 31565407
BMJ Glob Health. 2017 Nov 25;2(4):e000376
pubmed: 29225948
JAMA. 2015 Dec 1;314(21):2263-70
pubmed: 26624825
Lancet Glob Health. 2018 Mar;6(3):e342-e350
pubmed: 29396220
World J Surg. 2020 Jul;44(7):2123-2130
pubmed: 32274536
Int J Gynaecol Obstet. 2011 Dec;115(3):300-9
pubmed: 21982854
BMC Public Health. 2012 Nov 16;12:991
pubmed: 23158554
Int J Gynaecol Obstet. 2020 Aug;150(2):213-221
pubmed: 32306384
Br J Surg. 2019 Jan;106(2):e129-e137
pubmed: 30620069
BMJ Glob Health. 2019 May 22;4(3):e001488
pubmed: 31263588
Int J Health Geogr. 2017 Jan 13;16(1):1
pubmed: 28086893
PLoS One. 2019 Sep 16;14(9):e0222488
pubmed: 31525226
Int J Health Geogr. 2012 May 15;11(1):15
pubmed: 22587023
Lancet. 2015 Aug 8;386(9993):569-624
pubmed: 25924834
Int J Health Geogr. 2008 Dec 16;7:63
pubmed: 19087277