title: Maternal and neonatal outcomes at an alongside birth center and at a hospital.
abstract: OBJECTIVE
  To compare maternal and neonatal outcomes in low-risk women assisited in an alongside birth center and at a hospital.
  
  
  METHODS
  A cross-sectional study was conducted with a representative sample of low-risk women in São Paulo (Southeastern Brazil), from 2003 to 2006. The study included 991 women who delivered a child at the alongside birth center and 325 who delivered a child at a hospital. Data were obtained from medical records. A comparative analysis was performed for all of the women, who were stratified according to parity. The chi-square test and Fisher's exact test were used to compare outcomes between women who delivered in alongside birth center and those who gave birth in the hospital.
  
  
  RESULTS
  There was a homogeneous distribution of women according to parity (45.4% were nulliparous, and 54.6% had one or more previous deliveries). Statistically significant differences were found in the frequency of amniotomy (more frequent in nulliparous women treated at the hospital), the use of oxytocin during labor, and the use of postpartum analgesia (both more frequent among women of any parity treated at the hospital). The rate of episiotomy was higher in nulliparous women, both in the alongside birth center and at the hospital. Neonatal interventions were more frequent at the hospital and included aspiration of the upper airways, gastric aspiration, gastric lavage, and the use of an open oxygen mask. Other events that occurred with greater frequency at the hospital included caput succedaneum, respiratory discomfort, and admittance to the neonatal unit. There was no difference in Apgar scores at the fifth minute or cases of maternal or perinatal death.
  
  
  CONCLUSIONS
  Care at the alongside birth center involved fewer interventions and had maternal and neonatal outcomes similar to those of the hospital setting.
authors.affiliation: Curso de Obstetrícia, Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, SP, Brasil. camillaschneck@usp.br
authors.forename: Camilla Alexsandra
authors.initials: CA
authors.lastname: Schneck
authors.forename: Maria Luiza Gonzalez
authors.initials: ML
authors.lastname: Riesco
authors.forename: Isabel Cristina
authors.initials: IC
authors.lastname: Bonadio
authors.forename: Carmem Simone Grilo
authors.initials: CS
authors.lastname: Diniz
authors.forename: Sonia Maria Junqueira Vasconcellos de
authors.initials: SM
authors.lastname: Oliveira
mesh_terms: D000293:Adolescent; D000328:Adult; D001034:Apgar Score; D016550:Birthing Centers / Q000706:statistics & numerical data*; D001938:Brazil; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006769:Hospitals, General / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D008423:Maternal Age; D008430:Maternal-Child Health Centers / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D010298:Parity; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult