Maternal and newborn outcomes in planned home birth vs planned hospital births: a metaanalysis

Objective We sought to systematically review the medical literature on the maternal and newborn safety of planned home vs planned hospital birth. Study Design We included English-language peer-reviewed publications from developed Western nations reporting maternal and newborn outcomes by planned del...

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Bibliographic Details
Published in:American journal of obstetrics and gynecology 2010-09, Vol.203 (3), p.243.e1-243.e8
Main Authors: Wax, Joseph R., MD, Lucas, F. Lee, PhD, Lamont, Maryanne, MLS, Pinette, Michael G., MD, Cartin, Angelina, Blackstone, Jacquelyn, DO
Format: Article
Language:English
Subjects:
Analgesia, Epidural - utilization
Analgesia, Obstetrical - utilization
Biological and medical sciences
Birth Weight
Cardiotocography - utilization
Delivery, Obstetric
Episiotomy - statistics & numerical data
Female
Gynecology. Andrology. Obstetrics
Home Childbirth
Hospitalization
Humans
Infant Mortality
Infant, Newborn
Medical sciences
neonatal mortality
Obstetrics and Gynecology
patient safety
Perinatal Mortality
Perineum - injuries
Placenta, Retained - epidemiology
planned home childbirth
Pregnancy
Pregnancy Complications, Infectious - epidemiology
Pregnancy, Prolonged - epidemiology
Premature Birth - epidemiology
Respiration, Artificial - utilization
Uterine Hemorrhage - epidemiology
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Summary:Objective We sought to systematically review the medical literature on the maternal and newborn safety of planned home vs planned hospital birth. Study Design We included English-language peer-reviewed publications from developed Western nations reporting maternal and newborn outcomes by planned delivery location. Outcomes' summary odds ratios with 95% confidence intervals were calculated. Results Planned home births were associated with fewer maternal interventions including epidural analgesia, electronic fetal heart rate monitoring, episiotomy, and operative delivery. These women were less likely to experience lacerations, hemorrhage, and infections. Neonatal outcomes of planned home births revealed less frequent prematurity, low birthweight, and assisted newborn ventilation. Although planned home and hospital births exhibited similar perinatal mortality rates, planned home births were associated with significantly elevated neonatal mortality rates. Conclusion Less medical intervention during planned home birth is associated with a tripling of the neonatal mortality rate.
ISSN:0002-9378
1097-6868
DOI:10.1016/j.ajog.2010.05.028