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Planned Home Births Linked to Tripled Neonatal Mortality Rate

Also linked to fewer maternal interventions, less frequent prematurity and low birth weight

FRIDAY, July 2 (HealthDay News) -- Planned home births, which have fewer medical interventions than planned hospital births, are associated with a significantly higher neonatal mortality rate, according to research published online July 2 in the American Journal of Obstetrics & Gynecology.

Joseph R. Wax, M.D., of the Maine Medical Center in Portland, and colleagues systematically reviewed the medical literature for peer-reviewed publications from developed Western nations that reported newborn and maternal outcomes by planned birth location. They analyzed 342,056 planned home births and 207,551 planned hospital births.

The researchers found that planned home births were linked to fewer maternal interventions, such as operative delivery, episiotomy, epidural analgesia, and electronic fetal heart rate monitoring. Women who underwent planned home births were also less likely to incur lacerations, hemorrhage, and infections. In addition, neonatal outcomes of these births were associated with less frequent prematurity, low birth weight, and assisted newborn ventilation. However, planned home births were linked to significantly higher neonatal morality rates compared with planned hospital births, though the two had similar perinatal mortality rates.

"Of concern, this investigation identified a doubling and tripling of the neonatal mortality rate overall and among nonanomalous offspring, respectively, in planned home compared to planned hospital births," the authors write. "This finding is particularly robust considering the homogeneity of the observation across studies. It is especially striking as women planning home births were of similar and often lower obstetric risk than those planning hospital births."

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