SMFM: Maternal Benefits, Fetal Risks of Home Births Identified

Lower risk of C-sections, but increased risk of Apgar <;7 and neonatal seizures for home births

FRIDAY, Feb. 10 (HealthDay News) -- For women who have or intend to have births outside of a hospital, the risk of cesarean delivery is significantly lower, but there is an increased risk of lower five-minute Apgar score and neonatal seizures compared with hospital births, according to a study presented at the annual meeting of the Society for Maternal-Fetal Medicine, held from Feb. 6 to 11 in Dallas.

Yvonne W. Cheng, M.D., Ph.D., from the University of California in San Francisco, and colleagues investigated whether neonatal outcomes differ for intended home births and births that occur at birthing centers versus hospitals. Neonatal outcomes were compared for 2,296,953 singleton, live, term births, according to location of delivery.

The researchers found that 0.47 percent of births occurred at birthing centers, while 0.54 percent of women had intended home births. The risk of cesarean section was significantly lower for women who intended to, or delivered, outside of a hospital (0.02 to 4 percent versus 24 percent; P < 0.001). However, for intended home births, there was a significantly increased risk of five-minute Apgar score lower than 7 (adjusted odds ratio [aOR], 2.08; 95 percent confidence interval [CI], 1.68 to 2.34), and neonatal seizures (aOR, 2.83; 95 percent CI, 1.40 to 5.71) compared with births in the hospital.

"This trade-off between maternal benefit and neonatal risk of deliveries outside of hospital should be weighed in the decision regarding birthing facility preferences," the authors write.

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