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Maternal and newborn morbidity by birth facility among selected United States 2006 low-risk births

Published:December 14, 2009DOI:https://doi.org/10.1016/j.ajog.2009.09.037

      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.

      Key words

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