Home versus hospital birth

  • Review
  • Intervention

Authors


Abstract

Background

A meta-analysis of observational studies have suggested that planned home birth may be safe and with less interventions than planned hospital birth.

Objectives

The objective of this review was to assess the effects of planned home birth compared to hospital birth on the rates of interventions, complications and morbidity as determined in randomized trials.

Search methods

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (April 2006).

Selection criteria

Controlled trials comparing planned hospital birth to planned home birth in selected women, assisted by an experienced home birth practitioner, and backed up by a modern hospital system in case transfer should be necessary.

Data collection and analysis

Trial quality was assessed and data were extracted by one review author and checked by the other author. Study authors were contacted for additional information.

Main results

One study involving 11 women was included. The trial was of reasonable quality, but was too small to be able to draw conclusions.

Authors' conclusions

There is no strong evidence to favour either planned hospital birth or planned home birth for low-risk pregnant women.

摘要

背景

家居生產和醫院生產之比較

結合分析觀察性研究後,發現計劃性家居生產和醫院生產比較起來,家居生產可能仍是安全的,但卻有較少的醫療介入

目標

這篇評論的目的,主要是以隨機取樣試驗來評估計劃性家居生產和醫院生產在醫療介入,併發症和罹病率上的結果差別

搜尋策略

我們搜尋了 Cochrane Pregnancy and Childbirth Group's Trials Register (搜尋到2006年4月)

選擇標準

選擇特定婦女來進行對照性實驗以比較計劃性家居生產和醫院生產,家居生產由有經驗的醫療人員執行,且須選擇一家現代化醫院系統作為轉院時的後送機構

資料收集與分析

實驗品質和資料分析主要由一位評論作者負責,並經由另一位作者檢查。當需進一步資訊時則可詢問這些研究作者們

主要結論

一項研究只選入11位婦女參與。雖然這項實驗有合理的品質,但因個案數目太少而無法訂出結論

作者結論

對於低風險的孕婦,無足夠證據可以做出在家或在院生產的建議

翻譯人

本摘要由周產期醫學會(Taiwan Society of Perinatology)王鐸聲翻譯

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌

總結

對於低風險的孕婦,沒有足夠證據可以比較出在家或在院生產的優點和安全性。在某些國家幾乎所有孕婦都在醫院生產,相反的有些國家只要是健康或低風險的孕婦,會優先選擇家居生產。本世紀以來許多國家將低風險的孕婦改到醫院生產的改變無法有明顯實證支持。低風險的孕婦改到醫院生產甚至有可能增加多餘的醫療介入和併發症。經過搜尋資料庫後發現這方面只有一個小型實驗,其結果顯示對於低風險的孕婦,無明顯證據比較計劃性家居生產和醫院生產何者較優

Plain language summary

Home versus hospital birth

No strong evidence about the benefits and safety of planned home birth compared to planned hospital birth for low-risk pregnant women.

In some countries almost all births happen in hospital, whereas in other countries home birth is considered the first choice for healthy and otherwise low-risk women. The change to planned hospital birth for low-risk pregnant women in many countries during this century was not supported by good evidence. Planned hospital birth may even increase unnecessary interventions and complications without any benefit for low-risk women. The review found only one small trial, which provided no strong evidence to favour either planned hospital birth or planned home birth for low-risk pregnant women.

Ancillary