Objective: To describe perinatal outcomes (mortality, weight, condition at birth) at an isolated, rural hospital.
Design: A retrospective cohort study.
Study population: Neonates born to women beyond 20 weeks' gestation who delivered in the Bella Coola General Hospital (BCGH) between Mar. 7, 1940, and June 9, 2001, inclusive.
Main outcome measures: Information collected from the labour and delivery case room record book includes Aboriginal status, date of delivery, birth weight, newborn mortality, and newborn condition at birth.
Results: There were 2373 deliveries, including 12 sets of twins. Total newborn mortality rates declined from approximately 4.7% in the 1940-1954 time period to 0.7% in the 1970-1984 time period and have remained near that level ever since. From 1940-1960 BCGH's perinatal mortality rate was higher than Canada's; it was lower than Canada's in the 1970s, higher in the 1980s and about the same for the 1990s. The condition of the vast majority (approximately 90%) of newborns was described as being "good" at birth. Approximately 5% of newborns had birth weights < 2500 g, and this has not changed much over the years. In the 1951-1962 time period Aboriginal women had a higher percentage (8%) of infants with birth weight < 2500 g compared with non-Aboriginal women (5%), but this percentage has declined over time to the point where the rate for both groups is now around 5%.
Conclusions: Women giving birth in the low technology environment of the BCGH experienced acceptable neonatal outcomes. Trends in perinatal mortality, morbidity and low-birth-weight rates mirror those recorded for Canada.