Neonatal outcomes
Neonatal outcomes of the two study groups are presented in Table 3 . We observed differences between the low annual volume and the high annual volume in the following outcomes: higher rates of neonatal jaundice (4.1% vs. 3.7%, p<0.01), higher rates of mechanical ventilation rates (0.3% vs 0.2%, p<0.01), and higher rates of composite adverse neonatal outcome (10.9% vs. 10.3%, p<0.01). Other neonatal outcomes were comparable between the study groups.
Multivariate regression analysis adjusted for: maternal age, parity, gestational age, TOLAC, oxytocin augmentation, persistent occipito-posterior and CNMs’ practice duration revealed an independent significant positive risk association between low annual volume and mechanical ventilation, neonatal jaundice, and composite adverse neonatal outcome (aOR 1.32, 95% CI [1.05-1.66], aOR 1.07, 95% CI [1.00-1.14]. and aOR 1.05 (1.01-1.09) respectively)