Document Detail


Outcomes of planned home births in Washington State: 1989-1996.
MedLine Citation:
PMID:  12151146     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine whether there was a difference between planned home births and planned hospital births in Washington State with regard to certain adverse infant outcomes (neonatal death, low Apgar score, need for ventilator support) and maternal outcomes (prolonged labor, postpartum bleeding). METHODS: We examined birth registry information from Washington State during 1989-1996 on uncomplicated singleton pregnancies of at least 34 weeks' gestation that either were delivered at home by a health professional (N = 5854) or were transferred to medical facilities after attempted delivery at home (N = 279). These intended home births were compared with births of singletons planned to be born in hospitals (N = 10,593) during the same years. RESULTS: Infants of planned home deliveries were at increased risk of neonatal death (adjusted relative risk [RR] 1.99, 95% confidence interval [CI] 1.06, 3.73), and Apgar score no higher than 3 at 5 minutes (RR 2.31, 95% CI 1.29, 4.16). These same relationships remained when the analysis was restricted to pregnancies of at least 37 weeks' gestation. Among nulliparous women only, these deliveries also were associated with an increased risk of prolonged labor (RR 1.73, 95% CI 1.28, 2.34) and postpartum bleeding (RR 2.76, 95% CI 1.74, 4.36). CONCLUSION: This study suggests that planned home births in Washington State during 1989-1996 had greater infant and maternal risks than did hospital births.
Authors:
Jenny W Y Pang; James D Heffelfinger; Greg J Huang; Thomas J Benedetti; Noel S Weiss
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Obstetrics and gynecology     Volume:  100     ISSN:  0029-7844     ISO Abbreviation:  Obstet Gynecol     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-08-01     Completed Date:  2002-08-22     Revised Date:  2009-10-26    
Medline Journal Info:
Nlm Unique ID:  0401101     Medline TA:  Obstet Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  253-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Epidemiology, University of Washington School of Public Health and Community Medicine, Seattle, Washington 98195, USA. jwpang@u.washington.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Apgar Score
Cohort Studies
Delivery Rooms / utilization*
Female
Home Childbirth / mortality,  statistics & numerical data*
Hospitalization / statistics & numerical data
Humans
Infant Mortality / trends*
Infant, Newborn
Matched-Pair Analysis
Middle Aged
Obstetric Labor Complications / diagnosis,  epidemiology*
Parity
Pregnancy
Pregnancy Outcome
Prevalence
Registries
Respiratory Distress Syndrome, Newborn / diagnosis,  epidemiology*
Risk Assessment
Risk Factors
Washington / epidemiology
Comments/Corrections
Comment In:
Obstet Gynecol. 2003 Jan;101(1):198; author reply 199-200   [PMID:  12521043 ]
Obstet Gynecol. 2003 Jan;101(1):198; author reply 199-200   [PMID:  12517666 ]
Birth. 2003 Mar;30(1):57-63   [PMID:  12581041 ]
Obstet Gynecol. 2003 Jan;101(1):199; author reply 199-200   [PMID:  12521044 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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