General obstetrics

You have full text access to this OnlineOpen article

Perinatal mortality and morbidity in a nationwide cohort of 529 688 low-risk planned home and hospital births

  1. A de Jonge1,
  2. BY van der Goes2,
  3. ACJ Ravelli3,
  4. MP Amelink-Verburg1,4,
  5. BW Mol2,
  6. JG Nijhuis5,
  7. J Bennebroek Gravenhorst1,
  8. SE Buitendijk1

Article first published online: 15 APR 2009

DOI: 10.1111/j.1471-0528.2009.02175.x

Issue

BJOG: An International Journal of Obstetrics & Gynaecology

BJOG: An International Journal of Obstetrics & Gynaecology

Volume 116, Issue 9, pages 1177–1184, August 2009

Additional Information

How to Cite

de Jonge, A., van der Goes, B., Ravelli, A., Amelink-Verburg, M., Mol, B., Nijhuis, J., Gravenhorst, J. B. and Buitendijk, S. (2009), Perinatal mortality and morbidity in a nationwide cohort of 529 688 low-risk planned home and hospital births. BJOG: An International Journal of Obstetrics & Gynaecology, 116: 1177–1184. doi: 10.1111/j.1471-0528.2009.02175.x

Author Information

  1. 1

    TNO Quality of Life, Leiden, the Netherlands

  2. 2

    Department of Obstetrics and Gynaecology, Amsterdam Medical Centre, Amsterdam, the Netherlands

  3. 3

    Department of Medical Informatics, Amsterdam Medical Centre, Amsterdam, the Netherlands

  4. 4

    Health Care Inspectorate, Rijswijk, the Netherlands

  5. 5

    Department of Obstetrics and Gynaecology, Maastricht University Medical Centre, Maastricht, the Netherlands

*Dr A de Jonge, TNO Quality of Life, P.O. Box 2215, 2301 CE Leiden, the Netherlands. Email ankdejonge@hotmail.com

Publication History

  1. Issue published online: 10 JUL 2009
  2. Article first published online: 15 APR 2009
  3. Accepted 26 February 2009. Published Online 15 April 2009.

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article (HTML) Get PDF (124K)

Keywords:

  • Midwifery;
  • perinatal mortality;
  • pregnancy outcome

Objective  To compare perinatal mortality and severe perinatal morbidity between planned home and planned hospital births, among low-risk women who started their labour in primary care.

Design  A nationwide cohort study.

Setting  The entire Netherlands.

Population  A total of 529 688 low-risk women who were in primary midwife-led care at the onset of labour. Of these, 321 307 (60.7%) intended to give birth at home, 163 261 (30.8%) planned to give birth in hospital and for 45 120 (8.5%), the intended place of birth was unknown.

Methods  Analysis of national perinatal and neonatal registration data, over a period of 7 years. Logistic regression analysis was used to control for differences in baseline characteristics.

Main outcome measures  Intrapartum death, intrapartum and neonatal death within 24 hours after birth, intrapartum and neonatal death within 7 days and neonatal admission to an intensive care unit.

Results  No significant differences were found between planned home and planned hospital birth (adjusted relative risks and 95% confidence intervals: intrapartum death 0.97 (0.69 to 1.37), intrapartum death and neonatal death during the first 24 hours 1.02 (0.77 to 1.36), intrapartum death and neonatal death up to 7 days 1.00 (0.78 to 1.27), admission to neonatal intensive care unit 1.00 (0.86 to 1.16).

Conclusions  This study shows that planning a home birth does not increase the risks of perinatal mortality and severe perinatal morbidity among low-risk women, provided the maternity care system facilitates this choice through the availability of well-trained midwives and through a good transportation and referral system.

View Full Article (HTML) Get PDF (124K)