The Influence of In‐Utero Transfer on Perinatal Mortality in a Tertiary Care Centre

Abstract

From March 1, 1986 through February 28, 1989 inclusive there was a total of 8,319 births with a birth-weight of 500 g or more at Royal North Shore Hospital (RNS). Three hundred and sixty one births (4.3%) resulted from in-utero transfer of high risk pregnancies (IUT); the remainder were booked at RNS. There were 141 perinatal deaths of which 55 (39%) occurred in infants transferred in-utero. For the whole population delivered at RNS the perinatal mortality rate was 17.0/1,000 births (10.8/1,000 for booked patients versus 152.4/1,000 for IUT births), the stillbirth rate was 7.1/1,000 births (5.4/1,000 for booked patients versus 44.3/1,000 for IUT births) and the neonatal mortality rate was 9.9/1,000 livebirths (5.4/1,000 for booked patients versus 113.0/1,000 for IUT livebirths). These data show that crude perinatal mortality statistics from individual hospitals do not necessarily reflect their standard of care. Although the infants transferred in-utero comprised only 4.3% of the total population they constituted more than one third of the perinatal deaths at RNS. Their very high group specific mortality rates are related to their degree of prematurity and associated maternal and neonatal conditions.