title: Maternal and neonatal infections and obstetrical outcome in water birth.
abstract: OBJECTIVE
  The goal of our study was to assess the effect of water birth on obstetrical outcome, the maternal and neonatal infection rate in a selected low risk collective.
  
  
  METHODS
  In this prospective observational study (1998-2002) 513 women, wished to have a water birth. The study was approved by the local ethical committee, informed consent was obtained. According to the course of delivery, we compared three groups: woman who had a water birth, a normal vaginal delivery after immersion and a normal vaginal delivery without immersion. Outcome measurements were maternal and fetal infection rate, obstetrical outcome parameters and relevant laboratory parameters.
  
  
  RESULTS
  The groups were comparable in terms of demographic and obstetric data. The maternal and neonatal infection rate and laboratory parameters showed no significant difference among the groups. There was no maternal infection related to water birth. There were five water born neonates and three neonates after normal vaginal delivery preceded by immersion with conjunctivitis. Significant differences were observed in obstetrical outcome parameters: less use of analgesia, shorter duration of first and second stage of labor, smaller episiotomy rate in water birth. In contrast no differences were seen in all observed fetal outcome parameters: APGAR score, arterial and venous pH, admission rate to neonatal intensive care unit.
  
  
  CONCLUSIONS
  Water birth is a valuable alternative to traditional delivery. The maternal and fetal infection rate was comparable to traditional deliveries. A careful selection of a low risk collective is essential to minimize potential risks.
authors.affiliation: Women's University Hospital Basel, Spitalstrasse 21, 4031 Basel, Switzerland. rzanetti@uhbs.ch
authors.forename: Rosanna A
authors.initials: RA
authors.lastname: Zanetti-Daellenbach
authors.forename: Sibil
authors.initials: S
authors.lastname: Tschudin
authors.forename: Xiao Yan
authors.initials: XY
authors.lastname: Zhong
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Holzgreve
authors.forename: Olav
authors.initials: O
authors.lastname: Lapaire
authors.forename: Irene
authors.initials: I
authors.lastname: Hösli
mesh_terms: D000328:Adult; D001034:Apgar Score; D016022:Case-Control Studies; D003234:Conjunctivitis, Bacterial / Q000209:etiology*; D005260:Female; D006771:Hospitals, Maternity; D006801:Humans; D007101:Immersion / Q000009:adverse effects; D007231:Infant, Newborn; D007747:Labor Stage, First / Q000502:physiology; D007748:Labor Stage, Second / Q000502:physiology; D009321:Natural Childbirth / Q000009:adverse effects / Q000379:methods; D011247:Pregnancy; D011446:Prospective Studies