Reducing early infant mortality in India: results of a prospective cohort of pregnant women utilizing emergency medical services

Objectives: To describe the demographic characteristics and clinical outcomes of neonates born within 7 days of public ambulance transport to hospitals across five states in India. Design: Prospective observational study. Setting: Five Indian states using a centralised EMS agency that transported 3.1 million pregnant women in 2014. Participants: Over 6 weeks in 2014, this study followed a convenience sample of 1,431 neonates born to women utilizing a public-private ambulance service for a ‘pregnancy related’ problem. Initial calls were deemed ‘pregnancy related’ if categorised by EMS dispatchers as ‘pregnancy’, ‘childbirth’, ‘miscarriage’ or ‘labour pains’. Interfacility transfers, patients absent on ambulance arrival, refusal of care, and neonates born to women beyond 7 days of using the service were excluded. Main outcome measures: Death at 2, 7 and 42 days after delivery. Results: Among 1,684 women, 1,411 gave birth to 1,431 newborns within 7 days of initial ambulance transport. Medi...

研究目的：描述印度五个邦内通过公共救护车转运、入院时间不超过7天的新生儿的人口统计学特征与临床结局。研究设计：前瞻性观察性研究。研究场景：印度五个邦使用的集中式急救医疗服务（EMS，Emergency Medical Services）机构，该机构2014年共转运310万名孕产妇。研究对象：2014年为期6周以上的研究中，纳入便利抽样的1431名新生儿，其母亲因"妊娠相关问题"使用公私合营救护车服务。初始呼叫被EMS调度员归类为"妊娠""分娩""流产"或"分娩疼痛"时，即判定为"妊娠相关"呼叫。需排除机构间转运、救护车抵达时患者缺席、拒绝诊疗，以及使用服务超过7天后分娩的新生儿。主要结局指标：分娩后2天、7天及42天的死亡率。结果：在1684名孕产妇中，1411人在首次救护车转运后7天内分娩，共诞下1431名新生儿。Medi...