Short summary

Prehospital births, though rare, carry high risks, particularly the need for neonatal resuscitation. While Denmark's exact incidence is unclear, other countries report that 0.19-0.42% of ambulance calls involve these cases. Uncommon fetal presentations can be dangerous if providers lack adequate skills. This study examines unplanned prehospital births in Southern Denmark, focusing on interventions, outcomes, and training needs to reduce neonatal mortality and complications.

Rationale

Prehospital births, defined as the delivery of a child while the mother is under the care of prehospital personnel, are rare. However, the exact proportion of prehospital births in Denmark remains unknown. Other countries estimate that these births occur in approximately 0.19-0.42% of ambulance missions. Such births carry an increased risk of complications for both the mother and the child, with some cases requiring neonatal resuscitation. While the number of prehospital births involving atypical fetal presentations is likely minimal, they do occur. Prehospital births with atypical fetal presentations can be potentially harmful to both the mother and the child, as the prehospital care provider may lack the necessary skills to perform specific manual interventions during delivery. This study intends to examine unplanned prehospital births in the Southern Denmark region, focusing on the interventions carried out by ambulance personnel during delivery and the associated 18-month outcomes for children born prehospital, as well as for planned births that encounter unexpected complications requiring contact with emergency medical services. These outcomes will be compared with data from children born in hospitals within the same timeframe in the Region of Southern Denmark. The study aims to address obstetric manual interventions that may be necessary to develop an educational program for prehospital care providers. This could hopefully contribute to reducing mortality among newborns delivered outside of hospitals and decrease the risk of developing other related complications.

Description of the cohort

The target population is children born prehospital in the Region of Southern Denmark from 2016 to 2024. The study population consists of children born prehospital while their mothers received care from emergency medical technicians, paramedics, or prehospital anaesthesiologists. These children will be compared to all children born in hospitals in the Region of Southern Denmark during the same period. Additionally, the mothers of children born both inside and outside the hospital will be compared across various parameters.

Data and biological material

For this study, categorical data (socioeconomic conditions, demographics, and diagnoses) and data from the national registry (National Patient Registry, Cause of Death) will be used.

Collaborating researchers and departments

Prehospital Research Unit, the Region of Southern Denmark

• Søren Mikkelsen, Professor, Head of Research

Department of Obstetrics, Odense University Hospital, Denmark

• Jan Stener Jørgensen, Professor, Head of Research

Department of Paediatrics, Odense University Hospital, Denmark

• Josefine Gradman, Associate Professor