Perinatal mortality and morbidity up to 28 days after birth among 743 070 low-risk planned home and hospital births: a cohort study based on three merged national perinatal databases.
BJOG
; 122(5): 720-8, 2015 Apr.
Article
en En
| MEDLINE
| ID: mdl-25204886
OBJECTIVE: To compare rates of adverse perinatal outcomes between planned home births versus planned hospital births. DESIGN: A nationwide cohort study. SETTING: The Netherlands. POPULATION: Low-risk women in midwife-led care at the onset of labour. METHODS: Analysis of national registration data. MAIN OUTCOME MEASURES: Intrapartum and neonatal death, Apgar scores, and admission to a neonatal intensive care unit (NICU) within 28 days of birth. RESULTS: Of the total of 814 979 women, 466 112 had a planned home birth and 276 958 had a planned hospital birth. For 71 909 women, their planned place of birth was unknown. The combined intrapartum and neonatal death rates up to 28 days after birth, including cases with discrepancies in the registration of the moment of death, were: for nulliparous women, 1.02 for planned home births versus 1.09 for planned hospital births, adjusted odds ratio (aOR) 0.99, 95% confidence interval (95% CI) 0.79-1.24; and for parous women, 0.59 versus 0.58, aOR 1.16, 95% CI 0.87-1.55. The rates of NICU admissions and low Apgar scores did not significantly differ among nulliparous women (NICU admissions up to 28 days, 3.41 versus 3.61, aOR 1.05, 95% CI 0.92-1.18). Among parous women the rates of Apgar scores below seven and NICU admissions were significantly lower among planned home births (NICU admissions up to 28 days, 1.36 versus 1.95, aOR 0.79, 95% CI 0.66-0.93). CONCLUSIONS: We found no increased risk of adverse perinatal outcomes for planned home births among low-risk women. Our results may only apply to regions where home births are well integrated into the maternity care system.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Morbilidad
/
Parto Obstétrico
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Mortalidad Perinatal
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Parto Domiciliario
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Hospitalización
Tipo de estudio:
Etiology_studies
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Observational_studies
/
Risk_factors_studies
Límite:
Female
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Humans
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Newborn
/
Pregnancy
País/Región como asunto:
Europa
Idioma:
En
Revista:
BJOG
Asunto de la revista:
GINECOLOGIA
/
OBSTETRICIA
Año:
2015
Tipo del documento:
Article
País de afiliación:
Países Bajos
Pais de publicación:
Reino Unido