Increased Neonatal Mortality Rates for Home Births
(HealthDay News) — Despite a higher neonatal mortality rate, home births have increased over the past decade, and the increased risk is associated with the location of a planned birth, rather than the credentials of the person delivering the baby, according to a study presented at the annual meeting of the Society for Maternal-Fetal Medicine, held from February 3–8 in New Orleans.
Amos Grunebaum, MD, from the New York Weill Cornell Medical College in New York City, and colleagues conducted a retrospective study using the US Centers for Disease Control and Prevention-linked birth/infant death data set for singleton live births from 2007–2009. Deliveries were classified by birth location and providers.
Of the 10,453,778 term deliveries that met the study criteria, the researchers found that 91.13% were by hospital physicians; 7.91% by hospital midwives; 0.29% by midwives in freestanding birthing centers; 0.46% by midwives at home; and 0.21% by others at home. Compared with those delivered by midwives in hospital (neonatal mortality: 3.1/10,000), the neonatal mortality was significantly increased for those delivered by midwives at freestanding birthing centers (6.3/10,000; relative risk, 2.03); midwives at home (13.2/10,000; relative risk, 4.32); and by others at home (18.2/10,000; relative risk, 5.87). The excess neonatal mortality was 10.2/10,000 births for midwives at home and 15.0/10,000 births for home births by others.
"This risk further increased to about seven-fold if this was the mother's first pregnancy, and to about ten-fold in pregnancies beyond 41 weeks," Grunebaum said in a statement.