Birth centre care over a 10-year period: infant morbidity during the first month after birth.
OBJECTIVE
To study morbidity during the first month of life affecting infants of mothers booked for birth centre care during pregnancy.


METHODS
3238 live single-born infants whose mothers were admitted to an in-hospital birth centre, located at South Hospital in Stockholm, between 1989 and 2000 were compared with 179,502 infants whose mothers received standard maternity care in the Stockholm region during the same period, and who fulfilled the same medical inclusion criteria as those of the birth centre group. Information on other exposures and outcomes was collected from the Swedish Medical Birth and Hospital Discharge Registers. Logistic regression analyses were performed to calculate the odds ratio (OR), using 95% confidence intervals (95% CI).


RESULTS
Compared with infants born in standard care, infants in the birth centre group had a higher risk of respiratory problems (OR 1.39; 95% CI 1.14-1.69), a difference correlated to less serious respiratory diagnoses. However, the difference was not statistically significant if the birth centre group was compared only with infants born in standard care at South Hospital (OR 1.18; 95% CI 0.94-1.47). Birth centre care was associated with a lower risk of fractures (OR 0.40; 95% CI 0.25-0.63).


CONCLUSIONS
Birth centre care was not associated with severe infant morbidity and even appeared to reduce the risk of birth trauma, such as clavicle and other fractures.
Gottvall
Karin
K
Department of Nursing, Karolinska Institute, Stockholm, Sweden. karin.gottvall@kbh.ki.se
Winbladh
Birger
B
Cnattingius
Sven
S
Waldenström
Ulla
U
D016550:Birthing Centers; D015331:Cohort Studies; D005260:Female; D006761:Hospitals; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000453:epidemiology / Q000401:mortality; D016015:Logistic Models; D008423:Maternal Age; D008427:Maternal Health Services / Q000592:standards; D009017:Morbidity; D005791:Patient Care / Q000592:standards* / Q000706:statistics & numerical data; D011247:Pregnancy; D012042:Registries; D012959:Socioeconomic Factors; D013548:Sweden / Q000453:epidemiology