Implications for practice and research

• ▪ This study provides some evidence that increased travel time to hospital may increase the incidence of adverse perinatal outcomes for high-risk women at term.

• ▪ Increased risk of adverse outcomes associated with travel time to hospital when in labour should be taken into account when considering centralising maternity services.

• ▪ Future research should separate low- and high-risk women with analyses conducted separately for each group.

• ▪ Future research should include data about mode of delivery and factors affecting neonatal mortality and morbidity postbirth such as pathological jaundice, Group B streptococcus infections, prolonged rupture of membranes and neonatal effects of analgesia and anaesthesia administered during labour.

Context

This study explored whether travel time to hospital exceeding 20 min increased neonatal mortality and morbidity in low- and high-risk women. Previous work indicated perinatal mortality was elevated in rural regions of The Netherlands compared with urban areas, which …