Midwife-to-newborn ratio and neonatal outcome in healthy term infants

Aim: To assess the effect of midwife-to-infant ratio on healthy term infant outcome. Methods: Infants were enrolled in an inhospital midwife-led centre and an obstetrician-led centre with different midwife-to-infant ratios (1:2.5-1:5 vs 1:7-1:15). The primary endpoint was exclusive breastfeeding rate; secondary endpoints were neonatal admission in neonatal care unit rate and length of hospital stay. Results: One hundred and ten infants were enrolled in both midwife- and obstetrician-led centre. Exclusive breastfeeding rate at discharge was higher (88% vs 78%, P =.048) in infants born in the midwife- than in the obstetrician-led centre. Admission rate in neonatal care units (9% vs 2%, P =.017) and stay in hospital duration (3.1 ± 1.8 vs 2.6 ± 0.8 days, P =.008) were higher in the obstetrician- than in the midwife-led centre. Birth in the midwife-led centre increased the likelihood of exclusive breastfeeding (OR: 2.04, 1.07-3.92), while newborns’ admission in neonatal care units decreased it (OR : 0.17, 0.07-0.43). Conclusion: Healthy term infants’ neonatal outcome is negatively associated with a low midwife-to-infant ratio which decreases exclusive breastfeeding rate and is associated with a higher likelihood of admission in neonatal care units and longer stay in hospital.