716 Impact of travel time on obstetric outcomes in pregnancies complicated by fetal congenital heart disease

Abstract

To identify if driving time had an impact on maternal, neonatal, or delivery outcomes in pregnancies affected by fetal congenital heart disease (CHD). We performed an IRB-approved retrospective cohort study at a tertiary care center with a pediatric cardiac service and a large patient catchment area. The study population included 169 pregnant women with ages ranging from 18-49. Each pregnancy was complicated by CHD and included infants delivered between 01/2011 and 05/2017. Chart review was conducted to determine patient demographics and obstetric outcomes. Travel times were approximated using Google Maps and divided into quartiles based upon equally distributed sample sizes. Of the study population, 16% of deliveries occurred unscheduled at other facilities. Of the deliveries occurring via scheduled induction at our hospital, increased driving time was not significantly associated with higher operative delivery rates (cesarean or assisted vaginal), longer stays in the hospital, or longer induction times (Table 1). Driving time was significantly associated with decreased 1-minute APGAR scores (β = -0.225; p = 0.0406) but had no other effects on neonatal outcomes (Table 2). In pregnancies affected by CHD, driving time does not seem to impact delivery or neonatal outcomes. We suggest that scheduling labor inductions should not be altered based on maternal distance from the hospital.View Large Image Figure ViewerDownload Hi-res image Download (PPT)