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To examine whether neonatal outcomes differ in women who intended home births, and births that occurred at birthing centers compared to hospitals.
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.
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%, p<0.001), the odds of 5-minute Apgar score<7 and neonatal seizure was significantly higher for intended home births compared to hospital birth (see Table) .
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.