39 Regional variations in childbirth interventions in the Netherlands Figure 3. Regional variation of paediatric involvement for women in midwife-led care and obstetrician-led care The reference category (OR of 1.0) is the weighted overall rate of the country. ρ (rho) is the coefficient between the two point markers in the figure (paediatric involvement for women in midwife-led versus obstetrician-led care), which corresponds with the correlation coefficient described in table 5. Neonatal and maternal outcomes The results of the multivariable analyses for the childbirth outcomes are described in table 3. The overall incidence of antepartum and intrapartum stillbirth was 0.12% and of neonatal mortality up to 7 days 0.08%, but the adjusted ORs did not vary significantly between regions (table 3; not shown in figures). Correlation coefficients were therefore not calculated for these outcomes. The incidence of Apgar score below 7 at 5 minutes varied significantly across regions from between 0.7% to 1.5%. For third and fourth degree perineal tear, incidences varied from between 1.8% to 3.2% and for PPH from between 3.7% to 6.9%. The only intervention and adverse outcome that were significantly correlated, were augmentation of labour after a spontaneous onset of labour and PPH (ρ = 0.87; table 8). 2
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