Underlying causes of neonatal deaths in term singleton pregnancies: home births versus hospital births in the United States
-
Amos Grünebaum
, Laurence B. McCullough
, Birgit Arabin , Joachim Dudenhausen , Brooke Orosz und Frank A. Chervenak
Abstract
Introduction:
The objective of this study was to evaluate the underlying causes of neonatal mortality (NNM) in midwife-attended home births and compare them to hospital births attended by a midwife or a physician in the United States (US).
Methods:
A retrospective cohort study of the Centers for Disease Control (CDC) linked birth/infant death data set (linked files) for 2008 through 2012 of singleton, term (≥37 weeks) births and normal newborn weights (≥2500 grams).
Results:
Midwife-attended home births had the highest rate of neonatal deaths [122/95,657 neonatal mortality (NNM) 12.75/10,000; relative risk (RR): 3.6, 95% confidence interval (CI) 3–4.4], followed by hospital physician births (8695/14,447,355 NNM 6.02/10,000; RR: 1.7 95% CI 1.6–1.9) and hospital midwife births (480/1,363,199 NNM 3.52/10,000 RR: 1). Among midwife-assisted home births, underlying causes attributed to labor and delivery caused 39.3% (48/122) of neonatal deaths (RR: 13.4; 95% CI 9–19.9) followed by 29.5% due to congenital anomalies (RR: 2.5; 95% CI 1.8–3.6), and 12.3% due to infections (RR: 4.5; 95% CI 2.5–8.1).
Comment:
There are significantly increased risks of neonatal deaths among midwife-attended home births associated with three underlying causes: labor and delivery issues, infections, and fetal malformations. This analysis of the causes of neonatal death in planned home birth shows that it is consistently riskier for newborns to deliver at home than at the hospital. Physicians, midwives, and other health care providers have a professional responsibility to share information about the clinical benefits and risks of clinical management.
References
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The authors stated that there are no conflicts of interest regarding the publication of this article.
©2017 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Editorial
- Intrapartum care
- Recommendation and Guidelines for Perinatal Practice
- Delivery modes in case of fetal malformations
- Review article
- Obstetric analgesia – update 2016
- Highlight articles
- Risk factors and outcomes in “well-selected” vaginal breech deliveries: a retrospective observational study
- Induction of labor in breech presentation at term: a retrospective cohort study
- Evaluating fetal head dimension changes during labor using open magnetic resonance imaging
- Risk factors of uterine rupture with a special interest to uterine fundal pressure
- Diagnostic accuracy of fetal scalp lactate for intrapartum acidosis compared with scalp pH
- Reference values for Lactate Pro 2™ in fetal blood sampling during labor: a cross-sectional study
- Linear and non-linear analysis of uterine contraction signals obtained with tocodynamometry in prediction of operative vaginal delivery
- Evaluation of simparteam – a needs-orientated team training format for obstetrics and neonatology
- Transient fetal blood redistribution associated with maternal supine position
- Original articles
- Underlying causes of neonatal deaths in term singleton pregnancies: home births versus hospital births in the United States
- Fourfold increase in prevalence of gestational diabetes mellitus after adoption of the new International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria
- Hematological changes in severe early onset growth-restricted fetuses with absent and reversed end-diastolic flow in the umbilical artery
- Breast milk feeding in infants with inherited metabolic disorders other than phenylketonuria – a 10-year single-center experience
- Clinical significance of a false positive glucose challenge test in patients with a high body mass index
- Obituary
- Obituary – Edward Ogata (1945–2017)
- Congress Calendar
- Congress Calendar
Artikel in diesem Heft
- Frontmatter
- Editorial
- Intrapartum care
- Recommendation and Guidelines for Perinatal Practice
- Delivery modes in case of fetal malformations
- Review article
- Obstetric analgesia – update 2016
- Highlight articles
- Risk factors and outcomes in “well-selected” vaginal breech deliveries: a retrospective observational study
- Induction of labor in breech presentation at term: a retrospective cohort study
- Evaluating fetal head dimension changes during labor using open magnetic resonance imaging
- Risk factors of uterine rupture with a special interest to uterine fundal pressure
- Diagnostic accuracy of fetal scalp lactate for intrapartum acidosis compared with scalp pH
- Reference values for Lactate Pro 2™ in fetal blood sampling during labor: a cross-sectional study
- Linear and non-linear analysis of uterine contraction signals obtained with tocodynamometry in prediction of operative vaginal delivery
- Evaluation of simparteam – a needs-orientated team training format for obstetrics and neonatology
- Transient fetal blood redistribution associated with maternal supine position
- Original articles
- Underlying causes of neonatal deaths in term singleton pregnancies: home births versus hospital births in the United States
- Fourfold increase in prevalence of gestational diabetes mellitus after adoption of the new International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria
- Hematological changes in severe early onset growth-restricted fetuses with absent and reversed end-diastolic flow in the umbilical artery
- Breast milk feeding in infants with inherited metabolic disorders other than phenylketonuria – a 10-year single-center experience
- Clinical significance of a false positive glucose challenge test in patients with a high body mass index
- Obituary
- Obituary – Edward Ogata (1945–2017)
- Congress Calendar
- Congress Calendar