Outcomes associated with planned place of birth among low-risk pregnancies in Ontario, Canada (2012-2021): A protocol for a population-based propensity score weighted cohort study
Evidence suggests that for low-risk pregnancies, planned home births attended by a skilled health professional in settings where such services are well integrated are associated with lower risk of intrapartum interventions and no increase in adverse health outcomes. Monitoring and updating evidence...
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| creator | Darling, Elizabeth K Hébert, Vanessa Muraca, Giulia Reitsma, Angela |
| description | Evidence suggests that for low-risk pregnancies, planned home births attended by a skilled health professional in settings where such services are well integrated are associated with lower risk of intrapartum interventions and no increase in adverse health outcomes. Monitoring and updating evidence on the safety of planned home births is necessary to inform ongoing clinical and policy decisions.
This protocol describes a population-based retrospective cohort study which aims to compare risk of (a) neonatal morbidity and mortality, and (b) maternal outcomes and birth interventions, between people at low obstetrical risk with a planned home birth with a midwife, a planned a hospital birth with a midwife, or a planned hospital birth with a physician. The study population will include Ontario residents who gave birth in Ontario, Canada between April 1, 2012, and March 31, 2021. We will use data collected prospectively in a provincial perinatal data registry. The primary outcome will be severe neonatal morbidity or mortality, a composite binary outcome that includes one or more of the following conditions: stillbirth during the intrapartum period, neonatal death (death of a liveborn infant in the first 28 completed days of life), five-minute Apgar score |
| doi_str_mv | 10.1371/journal.pone.0302489 |
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This protocol describes a population-based retrospective cohort study which aims to compare risk of (a) neonatal morbidity and mortality, and (b) maternal outcomes and birth interventions, between people at low obstetrical risk with a planned home birth with a midwife, a planned a hospital birth with a midwife, or a planned hospital birth with a physician. The study population will include Ontario residents who gave birth in Ontario, Canada between April 1, 2012, and March 31, 2021. We will use data collected prospectively in a provincial perinatal data registry. The primary outcome will be severe neonatal morbidity or mortality, a composite binary outcome that includes one or more of the following conditions: stillbirth during the intrapartum period, neonatal death (death of a liveborn infant in the first 28 completed days of life), five-minute Apgar score <4, or infant resuscitation requiring cardiac compressions. We will conduct a stratified analysis with three strata: nulliparous, parous-no previous caesarean birth, and parous-prior caesarean birth. To reduce the impact of selection bias in estimating the effect of planned place of birth on neonatal and maternal outcomes, we will use propensity score (PS) overlap weighting (OW) and modified Poisson regression to conduct multivariate analyses.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0302489</identifier><identifier>PMID: 38739579</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Apgar Score ; Biology and Life Sciences ; Birth ; Births ; Censuses ; Childbirth ; Childbirth & labor ; Cohort analysis ; Cohort Studies ; Datasets ; Death ; Death & dying ; Delivery, Obstetric - statistics & numerical data ; Diabetes ; Evidence ; Female ; Gestational age ; Health services ; Home births ; Home Childbirth - statistics & numerical data ; Hospitals ; Humans ; Hypertension ; Infant ; Infant Mortality ; Infant, Newborn ; Infants ; Infants (Newborn) ; Intervention ; Maternal and infant welfare ; Medical decision making ; Medical personnel ; Medicine and Health Sciences ; Methicillin ; Midwifery ; Midwives ; Morbidity ; Mortality ; Mothers ; Neonates ; Newborn babies ; Ontario - epidemiology ; Patient outcomes ; Pediatric cardiology ; People and Places ; Personal health ; Physicians ; Population ; Population studies ; Pregnancy ; Pregnancy Outcome - epidemiology ; Pregnant women ; Privacy Act-Canada ; Propensity Score ; Retrospective Studies ; Risk ; Social exclusion ; Study Protocol ; Weighting</subject><ispartof>PloS one, 2024-05, Vol.19 (5), p.e0302489-e0302489</ispartof><rights>Copyright: © 2024 Darling et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</rights><rights>COPYRIGHT 2024 Public Library of Science</rights><rights>2024 Darling et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2024 Darling et al 2024 Darling et al</rights><rights>2024 Darling et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c543t-f52861a32d7f3e16f70c769ff284413817515edfe73792535aeb0277dcf0fcb63</cites><orcidid>0000-0003-2675-3222 ; 0000-0003-4618-0839</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11090366/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11090366/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,2096,2915,23847,27325,27905,27906,33755,53772,53774,79349,79350</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38739579$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Campbell, Emma</contributor><creatorcontrib>Darling, Elizabeth K</creatorcontrib><creatorcontrib>Hébert, Vanessa</creatorcontrib><creatorcontrib>Muraca, Giulia</creatorcontrib><creatorcontrib>Reitsma, Angela</creatorcontrib><title>Outcomes associated with planned place of birth among low-risk pregnancies in Ontario, Canada (2012-2021): A protocol for a population-based propensity score weighted cohort study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Evidence suggests that for low-risk pregnancies, planned home births attended by a skilled health professional in settings where such services are well integrated are associated with lower risk of intrapartum interventions and no increase in adverse health outcomes. Monitoring and updating evidence on the safety of planned home births is necessary to inform ongoing clinical and policy decisions.
This protocol describes a population-based retrospective cohort study which aims to compare risk of (a) neonatal morbidity and mortality, and (b) maternal outcomes and birth interventions, between people at low obstetrical risk with a planned home birth with a midwife, a planned a hospital birth with a midwife, or a planned hospital birth with a physician. The study population will include Ontario residents who gave birth in Ontario, Canada between April 1, 2012, and March 31, 2021. We will use data collected prospectively in a provincial perinatal data registry. The primary outcome will be severe neonatal morbidity or mortality, a composite binary outcome that includes one or more of the following conditions: stillbirth during the intrapartum period, neonatal death (death of a liveborn infant in the first 28 completed days of life), five-minute Apgar score <4, or infant resuscitation requiring cardiac compressions. We will conduct a stratified analysis with three strata: nulliparous, parous-no previous caesarean birth, and parous-prior caesarean birth. 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epidemiology</subject><subject>Patient outcomes</subject><subject>Pediatric cardiology</subject><subject>People and Places</subject><subject>Personal health</subject><subject>Physicians</subject><subject>Population</subject><subject>Population studies</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome - epidemiology</subject><subject>Pregnant women</subject><subject>Privacy Act-Canada</subject><subject>Propensity Score</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Social exclusion</subject><subject>Study Protocol</subject><subject>Weighting</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>BHHNA</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>DOA</sourceid><recordid>eNptUttu1DAQjRCIlsIfILDES5HI4ktsJ31Bq4pLpUp9gWfLcexdl6wn2A5Vv4sfxKHbqkWVH8Yen3Nmxj5V9ZrgFWGSfLyEOQY9riYIdoUZpk3bPakOScdoLShmT-_tD6oXKV1izFkrxPPqgLWSdVx2h9Wfizkb2NmEdEpgvM52QFc-b9E06hDKoURjETjU-1jSegdhg0a4qqNPP9EU7SboYHxR8AFdhKyjhw_oVAc9aHRMMaE1xZS8P0HrgoYMBkbkICKNJpjmUWcPoe51WmpFmGxIPl-jZCBadGX9Zru0ZGALMaOU5-H6ZfXM6THZV_t4VP348vn76bf6_OLr2en6vDa8Ybl2nLaCaEYH6ZglwklspOico23TENYSyQm3g7OSyY5yxrXtMZVyMA470wt2VL290Z1GSGr_3kkxLDraSs5lQZzdIAbQl2qKfqfjtQLt1b8ExI3SMXszWkWGrredZr2WbWMH3lIupBOmb3veMrdofdpXm_udHYwNOerxgejDm-C3agO_FSG4w0ws_R7vFSL8mm3KaueTsWP5SAvz0jhv2gYXrxTou_-gj4-3R210mcAHB6WwWUTVWnZMMCLaBbV6BFXWYHfeFHc6X_IPCM0NwURIKVp3NyTBavH2bTNq8bbae7vQ3tx_oDvSrZnZX2TI9-k</recordid><startdate>20240513</startdate><enddate>20240513</enddate><creator>Darling, Elizabeth K</creator><creator>Hébert, Vanessa</creator><creator>Muraca, Giulia</creator><creator>Reitsma, Angela</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U4</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHHNA</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWI</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>WZK</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-2675-3222</orcidid><orcidid>https://orcid.org/0000-0003-4618-0839</orcidid></search><sort><creationdate>20240513</creationdate><title>Outcomes associated with planned place of birth among low-risk pregnancies in Ontario, Canada (2012-2021): A protocol for a population-based propensity score weighted cohort study</title><author>Darling, Elizabeth K ; Hébert, Vanessa ; Muraca, Giulia ; Reitsma, Angela</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c543t-f52861a32d7f3e16f70c769ff284413817515edfe73792535aeb0277dcf0fcb63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adult</topic><topic>Apgar Score</topic><topic>Biology and Life Sciences</topic><topic>Birth</topic><topic>Births</topic><topic>Censuses</topic><topic>Childbirth</topic><topic>Childbirth & labor</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Datasets</topic><topic>Death</topic><topic>Death & dying</topic><topic>Delivery, Obstetric - 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Monitoring and updating evidence on the safety of planned home births is necessary to inform ongoing clinical and policy decisions.
This protocol describes a population-based retrospective cohort study which aims to compare risk of (a) neonatal morbidity and mortality, and (b) maternal outcomes and birth interventions, between people at low obstetrical risk with a planned home birth with a midwife, a planned a hospital birth with a midwife, or a planned hospital birth with a physician. The study population will include Ontario residents who gave birth in Ontario, Canada between April 1, 2012, and March 31, 2021. We will use data collected prospectively in a provincial perinatal data registry. The primary outcome will be severe neonatal morbidity or mortality, a composite binary outcome that includes one or more of the following conditions: stillbirth during the intrapartum period, neonatal death (death of a liveborn infant in the first 28 completed days of life), five-minute Apgar score <4, or infant resuscitation requiring cardiac compressions. We will conduct a stratified analysis with three strata: nulliparous, parous-no previous caesarean birth, and parous-prior caesarean birth. To reduce the impact of selection bias in estimating the effect of planned place of birth on neonatal and maternal outcomes, we will use propensity score (PS) overlap weighting (OW) and modified Poisson regression to conduct multivariate analyses.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>38739579</pmid><doi>10.1371/journal.pone.0302489</doi><orcidid>https://orcid.org/0000-0003-2675-3222</orcidid><orcidid>https://orcid.org/0000-0003-4618-0839</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | PloS one, 2024-05, Vol.19 (5), p.e0302489-e0302489 |
| issn | 1932-6203 1932-6203 |
| language | eng |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Sociological Abstracts; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adult Apgar Score Biology and Life Sciences Birth Births Censuses Childbirth Childbirth & labor Cohort analysis Cohort Studies Datasets Death Death & dying Delivery, Obstetric - statistics & numerical data Diabetes Evidence Female Gestational age Health services Home births Home Childbirth - statistics & numerical data Hospitals Humans Hypertension Infant Infant Mortality Infant, Newborn Infants Infants (Newborn) Intervention Maternal and infant welfare Medical decision making Medical personnel Medicine and Health Sciences Methicillin Midwifery Midwives Morbidity Mortality Mothers Neonates Newborn babies Ontario - epidemiology Patient outcomes Pediatric cardiology People and Places Personal health Physicians Population Population studies Pregnancy Pregnancy Outcome - epidemiology Pregnant women Privacy Act-Canada Propensity Score Retrospective Studies Risk Social exclusion Study Protocol Weighting |
| title | Outcomes associated with planned place of birth among low-risk pregnancies in Ontario, Canada (2012-2021): A protocol for a population-based propensity score weighted cohort study |
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