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
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 o...
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| Veröffentlicht in: | BJOG : an international journal of obstetrics and gynaecology 2015-04, Vol.122 (5), p.720-728 |
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| creator | Jonge, A Geerts, CC Goes, BY Mol, BW Buitendijk, SE Nijhuis, JG |
| description | 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. |
| doi_str_mv | 10.1111/1471-0528.13084 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1666724497</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3629323601</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4374-bf467baa189dae295085d8f80a15ead46d928d442ca0e10f590285ab48f069413</originalsourceid><addsrcrecordid>eNqFkU1u1jAQhiMEoj-wZocssWGTduw4jsOOVpQfVSoLWFuT2GlckjjYiarsOAJH6DlY9iicBCdf-RZs8MIzYz3zzlhvkrygcELjOaW8oCnkTJ7QDCR_lBzuXx5vOaSQMXmQHIVwA0AFg-xpcsByBlxKcZj8-my8HXDCjvTOx2CnheCg16qyeq3mkUyOMHl_p3EJBJvJeFJZP7UEezdck4Jn93dQAOnc7e8fP70N38jY4TAYTVrXm02vdWG065itM7whSGrXxpEkTLNeSIUh4m4gU-uNIb3x17GOm1k3xK5xv6aO9wqHZ8mTBrtgnj_E4-Trxbsv5x_Sy6v3H8_fXqY1zwqeVg0XRYVIZanRsDIHmWvZSECaG9Rc6JJJzTmrEQyFJi-ByRwrLhsQJafZcfJ6pzt69302YVK9DbXp4g-Nm4OiQoiCcV4WEX31D3rjZh_33yguaCEziNTpjqq9C8GbRo3e9ugXRUGttqrVRLWaqDZbY8fLB9256o3e8399jEC-A25tZ5b_6amzT1c74T8vca_p</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1664617830</pqid></control><display><type>article</type><title>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</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Jonge, A ; Geerts, CC ; Goes, BY ; Mol, BW ; Buitendijk, SE ; Nijhuis, JG</creator><creatorcontrib>Jonge, A ; Geerts, CC ; Goes, BY ; Mol, BW ; Buitendijk, SE ; Nijhuis, JG</creatorcontrib><description>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.</description><identifier>ISSN: 1470-0328</identifier><identifier>EISSN: 1471-0528</identifier><identifier>DOI: 10.1111/1471-0528.13084</identifier><identifier>PMID: 25204886</identifier><identifier>CODEN: BIOGFQ</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Apgar Score ; Childbirth & labor ; Databases, Factual ; Delivery, Obstetric - adverse effects ; Delivery, Obstetric - mortality ; Delivery, Obstetric - statistics & numerical data ; Female ; Home Childbirth - adverse effects ; Home Childbirth - mortality ; Home Childbirth - statistics & numerical data ; Home health care ; Homebirth ; Hospitalization - statistics & numerical data ; Hospitals ; Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Midwifery ; Morbidity ; Mortality ; Netherlands - epidemiology ; Odds Ratio ; Patient Admission - statistics & numerical data ; Patient Care Planning ; Perinatal Care ; Perinatal Mortality ; Pregnancy ; Pregnancy Outcome ; Prospective Studies ; Risk Factors ; Severity of Illness Index</subject><ispartof>BJOG : an international journal of obstetrics and gynaecology, 2015-04, Vol.122 (5), p.720-728</ispartof><rights>2014 Royal College of Obstetricians and Gynaecologists</rights><rights>2014 Royal College of Obstetricians and Gynaecologists.</rights><rights>Copyright © 2015 Royal College of Obstetricians and Gynaecologists</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4374-bf467baa189dae295085d8f80a15ead46d928d442ca0e10f590285ab48f069413</citedby><cites>FETCH-LOGICAL-c4374-bf467baa189dae295085d8f80a15ead46d928d442ca0e10f590285ab48f069413</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2F1471-0528.13084$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2F1471-0528.13084$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25204886$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jonge, A</creatorcontrib><creatorcontrib>Geerts, CC</creatorcontrib><creatorcontrib>Goes, BY</creatorcontrib><creatorcontrib>Mol, BW</creatorcontrib><creatorcontrib>Buitendijk, SE</creatorcontrib><creatorcontrib>Nijhuis, JG</creatorcontrib><title>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</title><title>BJOG : an international journal of obstetrics and gynaecology</title><addtitle>BJOG</addtitle><description>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.</description><subject>Apgar Score</subject><subject>Childbirth & labor</subject><subject>Databases, Factual</subject><subject>Delivery, Obstetric - adverse effects</subject><subject>Delivery, Obstetric - mortality</subject><subject>Delivery, Obstetric - statistics & numerical data</subject><subject>Female</subject><subject>Home Childbirth - adverse effects</subject><subject>Home Childbirth - mortality</subject><subject>Home Childbirth - statistics & numerical data</subject><subject>Home health care</subject><subject>Homebirth</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Intensive Care Units, Neonatal</subject><subject>Midwifery</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Netherlands - epidemiology</subject><subject>Odds Ratio</subject><subject>Patient Admission - statistics & numerical data</subject><subject>Patient Care Planning</subject><subject>Perinatal Care</subject><subject>Perinatal Mortality</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>Prospective Studies</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><issn>1470-0328</issn><issn>1471-0528</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1u1jAQhiMEoj-wZocssWGTduw4jsOOVpQfVSoLWFuT2GlckjjYiarsOAJH6DlY9iicBCdf-RZs8MIzYz3zzlhvkrygcELjOaW8oCnkTJ7QDCR_lBzuXx5vOaSQMXmQHIVwA0AFg-xpcsByBlxKcZj8-my8HXDCjvTOx2CnheCg16qyeq3mkUyOMHl_p3EJBJvJeFJZP7UEezdck4Jn93dQAOnc7e8fP70N38jY4TAYTVrXm02vdWG065itM7whSGrXxpEkTLNeSIUh4m4gU-uNIb3x17GOm1k3xK5xv6aO9wqHZ8mTBrtgnj_E4-Trxbsv5x_Sy6v3H8_fXqY1zwqeVg0XRYVIZanRsDIHmWvZSECaG9Rc6JJJzTmrEQyFJi-ByRwrLhsQJafZcfJ6pzt69302YVK9DbXp4g-Nm4OiQoiCcV4WEX31D3rjZh_33yguaCEziNTpjqq9C8GbRo3e9ugXRUGttqrVRLWaqDZbY8fLB9256o3e8399jEC-A25tZ5b_6amzT1c74T8vca_p</recordid><startdate>201504</startdate><enddate>201504</enddate><creator>Jonge, A</creator><creator>Geerts, CC</creator><creator>Goes, BY</creator><creator>Mol, BW</creator><creator>Buitendijk, SE</creator><creator>Nijhuis, JG</creator><general>Wiley Subscription Services, Inc</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>7QP</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201504</creationdate><title>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</title><author>Jonge, A ; Geerts, CC ; Goes, BY ; Mol, BW ; Buitendijk, SE ; Nijhuis, JG</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4374-bf467baa189dae295085d8f80a15ead46d928d442ca0e10f590285ab48f069413</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Apgar Score</topic><topic>Childbirth & labor</topic><topic>Databases, Factual</topic><topic>Delivery, Obstetric - adverse effects</topic><topic>Delivery, Obstetric - mortality</topic><topic>Delivery, Obstetric - statistics & numerical data</topic><topic>Female</topic><topic>Home Childbirth - adverse effects</topic><topic>Home Childbirth - mortality</topic><topic>Home Childbirth - statistics & numerical data</topic><topic>Home health care</topic><topic>Homebirth</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Intensive Care Units, Neonatal</topic><topic>Midwifery</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Netherlands - epidemiology</topic><topic>Odds Ratio</topic><topic>Patient Admission - statistics & numerical data</topic><topic>Patient Care Planning</topic><topic>Perinatal Care</topic><topic>Perinatal Mortality</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>Prospective Studies</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jonge, A</creatorcontrib><creatorcontrib>Geerts, CC</creatorcontrib><creatorcontrib>Goes, BY</creatorcontrib><creatorcontrib>Mol, BW</creatorcontrib><creatorcontrib>Buitendijk, SE</creatorcontrib><creatorcontrib>Nijhuis, JG</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jonge, A</au><au>Geerts, CC</au><au>Goes, BY</au><au>Mol, BW</au><au>Buitendijk, SE</au><au>Nijhuis, JG</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>BJOG : an international journal of obstetrics and gynaecology</jtitle><addtitle>BJOG</addtitle><date>2015-04</date><risdate>2015</risdate><volume>122</volume><issue>5</issue><spage>720</spage><epage>728</epage><pages>720-728</pages><issn>1470-0328</issn><eissn>1471-0528</eissn><coden>BIOGFQ</coden><abstract>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.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>25204886</pmid><doi>10.1111/1471-0528.13084</doi><tpages>9</tpages></addata></record> |
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| ispartof | BJOG : an international journal of obstetrics and gynaecology, 2015-04, Vol.122 (5), p.720-728 |
| issn | 1470-0328 1471-0528 |
| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Apgar Score Childbirth & labor Databases, Factual Delivery, Obstetric - adverse effects Delivery, Obstetric - mortality Delivery, Obstetric - statistics & numerical data Female Home Childbirth - adverse effects Home Childbirth - mortality Home Childbirth - statistics & numerical data Home health care Homebirth Hospitalization - statistics & numerical data Hospitals Humans Infant, Newborn Intensive Care Units, Neonatal Midwifery Morbidity Mortality Netherlands - epidemiology Odds Ratio Patient Admission - statistics & numerical data Patient Care Planning Perinatal Care Perinatal Mortality Pregnancy Pregnancy Outcome Prospective Studies Risk Factors Severity of Illness Index |
| title | 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 |
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