Maternal and newborn morbidity by birth facility among selected United States 2006 low-risk births
Received 20 May 2009; received in revised form 21 July 2009; accepted 30 September 2009. published online 14 December 2009.
Objective
We sought to evaluate perinatal morbidity by delivery location (hospital, freestanding birth center, and home).
Study Design
Selected 2006 US birth certificate data were accessed online from the Centers for Disease Control and Prevention. Low-risk maternal and newborn outcomes were tabulated and compared by birth facility.
Results
A total of 745,690 deliveries were included, of which 733,143 (97.0%) occurred in hospital, 4661 (0.6%) at birth centers, and 7427 (0.9%) at home. Compared with hospital deliveries, home and birthing center deliveries were associated with more frequent prolonged and precipitous labors. Home births experienced more frequent 5-minute Apgar scores <7. In contrast, home and birthing center deliveries were associated with less frequent chorioamnionitis, fetal intolerance of labor, meconium staining, assisted ventilation, neonatal intensive care unit admission, and birthweight <2500 g.
Conclusion
Home births are associated with a number of less frequent adverse perinatal outcomes at the expense of more frequent abnormal labors and low 5-minute Apgar scores.
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Maine Medical Center, Portland, ME
Reprints not available from the authors.
Cite this article as: Wax JR, Pinette MG, Cartin A, et al. Maternal and newborn morbidity by birth facility among selected United States 2006 low-risk births. Am J Obstet Gynecol 2010;202:152.e1-5.
ABSTRACT
Maternal and newborn morbidity by birth facility among selected United States 2006 low-risk births