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Study Weighs Risks and Benefits of Birthing Facilities

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Study Weighs Risks and Benefits of Birthing Facilities

In a study to be presented today at the Society for Maternal-Fetal Medicine’s annual meeting, The Pregnancy Meeting ™, in Dallas, Texas, researchers will report findings that indicate that the risk of obstetric intervention is lower for women who deliver or intend to deliver outside of hospitals, but there are some higher risks for newborns intended for home births compared to hospital births.

The study, Neonatal Outcomes Associated with Intended Place of Birth: Birth Centers and Home Birth Compared to Hospitals, examined whether neonatal outcomes differ in women who intended home births, and births that occurred at birthing centers compared to hospitals.  They found that the risk of cesarean delivery was significantly lower for women who had or intended to give birth outside of hospitals; however, the risk of neonatal seizure and a 5-minute Apgar score (which assesses the health of newborns) of less than seven was much higher for intended home births.

“This trade-off between maternal benefit and neonatal risk of deliveries outside of hospitals should be weighed in the decision regarding birthing facility preferences,” said Yvonne W. Cheng, MD, PhD, with the University of California, San Francisco, Obstetrics & Gynecology, San Francisco, Calif., and the study’s lead author.

In addition to Cheng, the study was conducted by Jonathan Snowden, PhD, and Aaron Caughey, MD, PhD, both with the Oregon Health & Science University, Department of Obstetrics and Gynecology, Portland, Ore.

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A copy of the abstract is available at http://www.smfmnewsroom.org/annual-meeting/2011-meeting-abstracts/.  For interviews please contact Vicki Bendure at Vicki@bendurepr.com, 540-687-3360 (office) or 202-374-9259 (cell), or Jacqueline Boggess at jacqueline@bendurepr.com, 540-687-5399 (office) or 202-738-3054 (cell).

The Society for Maternal-Fetal Medicine (est. 1977) is a non-profit membership group for obstetricians/gynecologists who have additional formal education and training in maternal-fetal medicine.  The society is devoted to reducing high-risk pregnancy complications by providing continuing education to its 2,000 members on the latest pregnancy assessment and treatment methods.  It also serves as an advocate for improving public policy, and expanding research funding and opportunities for maternal-fetal medicine.  The group hosts an annual scientific meeting in which new ideas and research in the area of maternal-fetal medicine are unveiled and discussed.  For more information, visit www.smfm.org or www.facebook.com/SocietyforMaternalFetalMedicine.

 

Abstract 65:

Neonatal outcomes associated with intended place of birth: birth centers and home birth compared to hospitals
Yvonne W. Cheng 1, Jonathan Snowden 2, Aaron Caughey 3

University of California, San Francisco, Obstetrics & Gynecology, San Francisco, CA, Oregon Health and Sciences University, Obstetrics and Gynecology, Portland, OR, Oregon Health & Science University, Department of Obstetrics and Gynecology, Portland, OR

OBJECTIVE: To examine whether neonatal outcomes differ in women who intended home births, and births that occurred at birthing centers compared to hospitals.

STUDY DESIGN: This was a retrospective cohort study of singleton live births that occurred in 2008 in the U.S. that had specified birthing facility information. Deliveries were categorized by location of occurrence: hospitals, birthing centers, or intended home births. Neonatal outcomes were compared using chi-square test and potential confounders adjusted for by multivariable logistic regression.

RESULTS: There were 2,296,953 singleton, live, term births meeting study criteria; of these, 10,726 (0.47%) delivered at birthing centers and 12,433 (0.54%) had intended home births. While the risk of cesarean delivery was much lower for women who delivered/or intend to deliver outside of hospitals (0.02-4% vs. 24%, p0.001), the odds of 5-minute Apgar score7 and neonatal seizure was significantly higher for intended home births compared to hospital birth (see Table).

CONCLUSION: The risk of cesarean delivery is significantly lower for women who had or intend to have births outside of hospitals; however, the risk of lower 5-minute Apgar score and neonatal seizure was higher for intended home births. This trade-off between maternal benefit and neonatal risk of deliveries outside of hospital should be weighed in the decision regarding birthing facility preferences.

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