Perinatal health inequalities and accessibility of maternity services in a rural French region: Closing maternity units in Burgundy |
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| Affiliation: | 1. Research Unit of Perinatal Epidemiology, Clinical Care and Management Innovation Research Area, Bambino Gesù Children''s Hospital, IRCCS, Rome, Italy;2. Hospital Network Planning and Research Area, Lazio Regional Health Authority, Rome, Italy;3. Hospital Care Services, General Directorate for Health and Social Policies, Emilia Romagna Region, Bologna, Italy;4. Neonatal Intensive Care Unit, Salesi Children''s Hospital, Ancona, Italy;5. Neonatal Intensive Care Unit, Department of Obstetrics and Pediatrics, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy;6. Clinical Care and Management Innovation Research Area, Bambino Gesù Children''s Hospital, IRCCS, Rome, Italy;7. INSERM, Obstetrics, Perinatal and Paediatric Epidemiology Research Team, Center for Epidemiology and Biostatistics (U1153), and DHU Risks in Pregnancy, Paris Descartes University, Paris, France |
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| Abstract: | Maternity unit closures in France have increased travel time for pregnant women in rural areas. We assessed the impact of travel time to the closest unit on perinatal outcomes and care in Burgundy using multilevel analyses of data on deliveries from 2000 to 2009. A travel time of 30 min or more increased risks of fetal heart rate anomalies, meconium-stained amniotic fluid, out-of-hospital births, and pregnancy hospitalizations; a positive but non-significant gradient existed between travel time and perinatal mortality. The effects of long travel distances on perinatal outcomes and care should be factored into closure decisions. |
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| Keywords: | Accessibility Perinatal health Maternity services Rural region Travel time |
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