{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T07:28:45Z","timestamp":1790494125232,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,12,3]],"date-time":"2013-12-03T00:00:00Z","timestamp":1386028800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To study the differences in neonatal outcome and treatment measures in Finnish obstetric units.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A registry study with Medical Birth Register data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting and population<\/jats:title><jats:p>All births (<jats:italic>n<\/jats:italic>\u00a0=\u00a02\u00a094\u00a0726) in Finland from 2006 to 2010 with a focus on term, singleton non\u2010university deliveries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All 34 delivery units were grouped into small (below 1000), mid\u2010sized (1000\u20132999) and large (3000 or more) units, and the adverse outcome rates in neonates were compared using logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Early neonatal deaths, stillbirths, Apgar scores, arterial cord <jats:styled-content style=\"fixed-case\">pH<\/jats:styled-content>, Erb's paralysis, respirator treatment, the proportion of post\u2010term deliveries (gestational age beyond 42\u00a0weeks) and the proportion of newborns still hospitalised 7\u00a0days after delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From an analysis of term, singleton non\u2010university deliveries, the early neonatal mortality was significantly higher in the small relative to the mid\u2010sized delivery units [odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>), 2.07; 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>), 1.19\u20133.60]. The rate of Erb's paralysis was lowest in the large units (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 0.65; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.50\u20130.84). The use of a respirator was more than two\u2010fold more common in large relative to mid\u2010sized units (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 2.38; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 2.00\u20132.83). The proportion of post\u2010term deliveries was highest in the large units (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 1.36; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.31\u20131.42), where a significantly higher percentage of post\u2010term newborns were still hospitalised after 7\u00a0days (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 1.50; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.19\u20131.89).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There are significant differences in several neonatal indicators dependent on the hospital size. An international consensus is needed on which indicators should be used.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.12507","type":"journal-article","created":{"date-parts":[[2013,12,3]],"date-time":"2013-12-03T05:40:48Z","timestamp":1386049248000},"page":"430-437","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Determining obstetric patient safety indicators: the differences in neonatal outcome measures between different\u2010sized delivery units"],"prefix":"10.1111","volume":"121","author":[{"given":"A","family":"Pyyk\u00f6nen","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Gissler","sequence":"additional","affiliation":[{"name":"THL National Institute for Health and Welfare Helsinki Finland"},{"name":"Nordic School of Public Health Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Jakobsson","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Helsinki University Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Pet\u00e4j\u00e4","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Pediatrics Helsinki University Central Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A\u2010M","family":"Tapper","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Pediatrics Helsinki University Central Hospital Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,12,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181ea4d4f"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1553-7250(06)32065-X"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005237-200501000-00007"},{"key":"e_1_2_6_5_1","first-page":"492e1","article-title":"Impact of a comprehensive patient safety strategy on obstetric adverse events","volume":"200","author":"Pettker CM","year":"2009","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_6_1","volume-title":"Catalogue of Patient Safety Indicators","author":"Kristensen S","year":"2007"},{"key":"e_1_2_6_7_1","volume-title":"OECD, Health at a Glance 2011: OECD Indicators","year":"2011"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2013.01.027"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgyn.2010.05.011"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2003.09.003"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2011.01078.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/140349489502300113"},{"key":"e_1_2_6_13_1","first-page":"207.e1","article-title":"The risk of fetal death: current concepts of best gestational age for delivery","volume":"208","author":"Mandujano A","year":"2013","journal-title":"Obstet Gynecol"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-323-06545-0.00029-7"},{"key":"e_1_2_6_15_1","unstructured":"Euro\u2010Peristat Project with SCPE and EUROCAT.European Perinatal Health Report. 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