Perinatal Outcomes in Babies Born before Arrival at Prince Mshiyeni Memorial Hospital in Durban, South Africa.

Objective: To evaluate the maternal demographics, incidence, perinatal outcomes, and characteristics of babies born before arrival (BBAs) to hospitals.

Methods: A prospective, observational study was conducted at a large maternity unit in Durban, KwaZulu-Natal. A total of 200 mothers who attended the hospital within 24 hours of an out-of-hospital birth were recruited and interviewed, and 142 participants were eligible. A total of 128 mothers who delivered their babies in hospital (inborns) were used as the control group. Specific maternal and neonatal characteristics were analysed.

Results: The incidence of BBAs was 2.2%. The percentage of premature neonates in the BBA group was 54% vs 17.9% for inborns (p ≤ 0.001). A total of 33.8% of BBA mothers were unbooked vs 2.4% of inborns (p ≤ 0.001). The majority (59%) of inborns were primigravidas whereas the majority (73.9%) in the BBA group were multigravidas (p ≤ 0.001). Women in the BBA group were more prone to genital tears (p ≤ 0.001). There were no significant differences in respect of NICU admission and all-cause mortality; however, an increased risk for hypothermia and hypoglycaemia was found.

Conclusion: BBAs are at a significant risk of prematurity, low birth weight, hypothermia, and hypoglycaemia and are prone to longer hospital stays.