Maternal and newborn morbidity by birth facility among selected United States 2006 low-risk births.
OBJECTIVE
We sought to evaluate perinatal morbidity by delivery location (hospital, freestanding birth center, and home).


METHODS
Selected 2006 US birth certificate data were accessed online from the Centers for Disease Control and Prevention. Low-risk maternal and newborn outcomes were tabulated and compared by birth facility.


RESULTS
A total of 745,690 deliveries were included, of which 733,143 (97.0%) occurred in hospital, 4661 (0.6%) at birth centers, and 7427 (0.9%) at home. Compared with hospital deliveries, home and birthing center deliveries were associated with more frequent prolonged and precipitous labors. Home births experienced more frequent 5-minute Apgar scores <7. In contrast, home and birthing center deliveries were associated with less frequent chorioamnionitis, fetal intolerance of labor, meconium staining, assisted ventilation, neonatal intensive care unit admission, and birthweight <2500 g.


CONCLUSIONS
Home births are associated with a number of less frequent adverse perinatal outcomes at the expense of more frequent abnormal labors and low 5-minute Apgar scores.
Wax
Joseph R
JR
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Maine Medical Center, Portland, ME, USA.
Pinette
Michael G
MG
Cartin
Angelina
A
Blackstone
Jacquelyn
J
D015331:Cohort Studies; D005260:Female; D006700:Home Childbirth / Q000009:adverse effects*; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D008880:Midwifery; D009017:Morbidity; D011247:Pregnancy; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States