title: Selected perinatal outcomes associated with planned home births in the United States.
abstract: OBJECTIVE
  More women are planning home birth in the United States, although safety remains unclear. We examined outcomes that were associated with planned home compared with hospital births.
  
  
  METHODS
  We conducted a retrospective cohort study of term singleton live births in 2008 in the United States. Deliveries were categorized by location: hospitals or intended home births. Neonatal outcomes were compared with the use of the χ(2) test and multivariable logistic regression.
  
  
  RESULTS
  There were 2,081,753 births that met the study criteria. Of these, 12,039 births (0.58%) were planned home births. More planned home births had 5-minute Apgar score <4 (0.37%) compared with hospital births (0.24%; adjusted odds ratio, 1.87; 95% confidence interval, 1.36-2.58) and neonatal seizure (0.06% vs 0.02%, respectively; adjusted odds ratio, 3.08; 95% confidence interval, 1.44-6.58). Women with planned home birth had fewer interventions, including operative vaginal delivery and labor induction/augmentation.
  
  
  CONCLUSIONS
  Planned home births were associated with increased neonatal complications but fewer obstetric interventions. The trade-off between maternal preferences and neonatal outcomes should be weighed thoughtfully.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, School of Medicine, San Francisco, CA.
authors.forename: Yvonne W
authors.initials: YW
authors.lastname: Cheng
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Snowden
authors.forename: Tekoa L
authors.initials: TL
authors.lastname: King
authors.forename: Aaron B
authors.initials: AB
authors.lastname: Caughey
mesh_terms: D000293:Adolescent; D000328:Adult; D001034:Apgar Score; D015331:Cohort Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D006700:Home Childbirth / Q000706:statistics & numerical data*; D006760:Hospitalization; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D007751:Labor, Induced / Q000706:statistics & numerical data; D016015:Logistic Models; D008880:Midwifery / Q000706:statistics & numerical data; D016017:Odds Ratio; D011247:Pregnancy; D012189:Retrospective Studies; D012640:Seizures / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: neonatal outcome; planned home birth