title: Birthplace in New South Wales, Australia: an analysis of perinatal outcomes using routinely collected data.
abstract: BACKGROUND
  The outcomes for women who give birth in hospital compared with at home are the subject of ongoing debate. We aimed to determine whether a retrospective linked data study using routinely collected data was a viable means to compare perinatal and maternal outcomes and interventions in labour by planned place of birth at the onset of labour in one Australian state.
  
  
  METHODS
  A population-based cohort study was undertaken using routinely collected linked data from the New South Wales Perinatal Data Collection, Admitted Patient Data Collection, Register of Congenital Conditions, Registry of Birth Deaths and Marriages and the Australian Bureau of Statistics. Eight years of data provided a sample size of 258,161 full-term women and their infants. The primary outcome was a composite outcome of neonatal mortality and morbidity as used in the Birthplace in England study.
  
  
  RESULTS
  Women who planned to give birth in a birth centre or at home were significantly more likely to have a normal labour and birth compared with women in the labour ward group. There were no statistically significant differences in stillbirth and early neonatal deaths between the three groups, although we had insufficient statistical power to test reliably for these differences.
  
  
  CONCLUSIONS
  This study provides information to assist the development and evaluation of different places of birth across Australia. It is feasible to examine perinatal and maternal outcomes by planned place of birth using routinely collected linked data, although very large data sets will be required to measure rare outcomes associated with place of birth in a low risk population, especially in countries like Australia where homebirth rates are low.
authors.affiliation: Centre for Midwifery, Child and Family Health, Faculty of Health Level 7, University of Technology, 235-253 Jones St, Broadway, Sydney, New South Wales, Australia. Caroline.Homer@uts.edu.au.
authors.forename: Caroline S E
authors.initials: CS
authors.lastname: Homer
authors.forename: Charlene
authors.initials: C
authors.lastname: Thornton
authors.forename: Vanessa L
authors.initials: VL
authors.lastname: Scarf
authors.forename: David A
authors.initials: DA
authors.lastname: Ellwood
authors.forename: Jeremy J N
authors.initials: JJ
authors.lastname: Oats
authors.forename: Maralyn J
authors.initials: MJ
authors.lastname: Foureur
authors.forename: David
authors.initials: D
authors.lastname: Sibbritt
authors.forename: Helen L
authors.initials: HL
authors.lastname: McLachlan
authors.forename: Della A
authors.initials: DA
authors.lastname: Forster
authors.forename: Hannah G
authors.initials: HG
authors.lastname: Dahlen
mesh_terms: D000328:Adult; D016550:Birthing Centers / Q000706:statistics & numerical data*; D002585:Cesarean Section / Q000706:statistics & numerical data; D003625:Data Collection / Q000379:methods*; D005113:Extraction, Obstetrical / Q000706:statistics & numerical data; D005260:Female; D006700:Home Childbirth / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D009517:New South Wales / Q000453:epidemiology; D007744:Obstetric Labor Complications / Q000453:epidemiology; D011247:Pregnancy; D050497:Stillbirth / Q000453:epidemiology; D055815:Young Adult