title: Planned home birth and the association with neonatal hypoxic ischemic encephalopathy.
abstract: OBJECTIVE
  To evaluate the association between planned home birth and neonatal hypoxic ischemic encephalopathy (HIE).
  
  
  METHODS
  This is a case-control study in which a database of neonates who underwent head cooling for HIE at our institution from 2007 to 2011 was linked to New York City (NYC) vital records. Four normal controls per case were then randomly selected from the birth certificate data after matching for year of birth, geographic location, and gestational age. Demographic and obstetric information was obtained from the vital records for both the cases and controls. Location of birth was analyzed as hospital or out of hospital birth. Details from the out of hospital deliveries were reviewed to determine if the delivery was a planned home birth. Maternal and pregnancy characteristics were examined as covariates and potential confounders. Logistic regression was used to determine the odds of HIE by intended location of delivery.
  
  
  RESULTS
  Sixty-nine neonates who underwent head cooling for HIE had available vital record data on their births. The 69 cases were matched to 276 normal controls. After adjusting for pregnancy characteristics and mode of delivery, neonates with HIE had a 44.0-fold [95% confidence interval (CI) 1.7-256.4] odds of having delivered out of hospital, whether unplanned or planned. Infants with HIE had a 21.0-fold (95% CI 1.7-256.4) increase in adjusted odds of having had a planned home birth compared to infants without HIE.
  
  
  CONCLUSIONS
  Out of hospital birth, whether planned home birth or unplanned out of hospital birth, is associated with an increase in the odds of neonatal HIE.
authors.affiliation: .
authors.forename: Shane W
authors.initials: SW
authors.lastname: Wasden
authors.affiliation: .
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Chasen
authors.affiliation: .
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Perlman
authors.affiliation: .
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Illuzzi
authors.affiliation: .
authors.forename: Frank A
authors.initials: FA
authors.lastname: Chervenak
authors.affiliation: .
authors.forename: Amos
authors.initials: A
authors.lastname: Grunebaum
authors.affiliation: .
authors.forename: Heather S
authors.initials: HS
authors.lastname: Lipkind
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006700:Home Childbirth / Q000706:statistics & numerical data*; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000453:epidemiology*; D007231:Infant, Newborn; D009519:New York City / Q000453:epidemiology; D011247:Pregnancy
keywords: Home birth; hypoxic ischemic encephalopathy; location of delivery; neonatal encephalopathy; neonatal hypoxic ischemic encephalopathy; out of hospital birth; planned home birth