Perinatale sterfte en morbiditeit bij geplande thuisbevallingen en poliklinische bevallingen

Translated title of the contribution: Perinatal death and morbidity in planned home births and hospital deliveries

A. de jonge, B. Y. van der Goes, A. C. J. Ravelli, M. P. Amelink- Verburg, B. W. Mol, J. G. Nijhuis, J. Gravenhorst, S. E. Buitendijk

Research output: Contribution to JournalArticleProfessional

Abstract

OBJECTIVE: To compare perinatal mortality and severe perinatal morbidity between planned home and hospital births among low risk women who commenced labour within the primary care system. DESIGN: A Dutch nationwide cohort study, descriptive. METHOD: Data from national perinatal and neonatal registries over a period of 7 years were used to compare perinatal mortality and morbidity among women with a low risk for a complicated delivery who planned to give birth either at home or in hospital. Analysis was according to 'intention-to-treat'. Logistic regression analysis was used to control for differences in baseline characteristics. RESULTS: A total of 529,688 low risk women received primary midwife-led care at the onset of labour. Of these, 321,307 (60.7%) intended to give birth at home, 163,261 (30.8%) planned to give birth in hospital and for 45,120 (8.5%) the preferred place of birth was unknown. In the total study population, there were 345 intrapartum and neonatal deaths up to 7 days (7 per 10,000) and 975 admissions to a neonatal intensive care unit (18 per 10,000). No statistically significant differences were found between planned home and planned hospital births in intrapartum death (adjusted relative risk (RR): 0.97; 95% CI: 0.69-1.37), intrapartum death and neonatal death during the first 24 hours (RR: 1.02; 95% CI: 0.77-1.36), intrapartum death and neonatal death up to 7 days (RR: 1.00; 95% CI: 0.78 to 1.27), or admission to a neonatal intensive care unit (RR: 1.00; 95% CI: 0.86-1.16). CONCLUSION: Choosing for home birth does not increase the risks of perinatal mortality and severe perinatal morbidity among low-risk women, providing there is a maternity care system in place for this, with well trained midwives and an adequate system for transport and referral
Translated title of the contributionPerinatal death and morbidity in planned home births and hospital deliveries
Original languageDutch
Pages (from-to)17-22
Number of pages7
JournalTijdschrift voor Verloskundigen
Volume34
Issue number48
Publication statusPublished - 28 Nov 2009

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