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Planned home births associated with tripling of neonatal mortality rate vs. planned hospital births
Date:7/1/2010

Philadelphia, PA, July 1, 2010 About 1 in 200 women in the US delivers her baby at home, with approximately 75% of these low-risk, single-baby births planned in advance as home deliveries. In a study published online today by the American Journal of Obstetrics & Gynecology (AJOG), researchers from Maine Medical Center, Portland, Maine, analyzed the results of multiple studies from around the world. They report that less medical intervention, characteristic of planned home births, is associated with a tripling of the neonatal mortality rate compared to planned hospital deliveries. Planned home births were characterized by a greater proportion of deaths attributed to respiratory distress and failed resuscitation.

"Our findings raise the question of a link between the increased neonatal mortality among planned home births and the decreased obstetric intervention in this group," according to lead investigator Joseph R. Wax, MD, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Maine Medical Center. "Women choosing home birth, particularly low-risk individuals who had given birth previously, are in large part successful in achieving their goal of delivering with less morbidity and medical intervention than experienced during hospital-based childbirth. Of significant concern, these apparent benefits are associated with a doubling of the neonatal mortality rate overall and a near tripling among infants born without congenital defects (nonanomalous). These findings echo concerns raised in a recent large US cohort study in which home births experienced significantly more 5-minute Apgar scores < 7 as compared to low-risk term hospital births, suggesting an increased need for resuscitation among home births. Therefore, the personnel, training, and equipment available for neonatal resuscitation represent other possible contributors to the excessive neonatal mortality rate among planned home births."

Investigators
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Contact: Andrea Boccelli
ajogmedia@elsevier.com
215-239-3713
Elsevier Health Sciences
Source:Eurekalert

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