Sentences with phrase «outcome in births planned»

There was no difference overall between birth settings in the incidence of the primary outcome (composite of perinatal mortality and intrapartum related neonatal morbidities), but there was a significant excess of the primary outcome in births planned at home compared with those planned in obstetric units in the restricted group of women without complicating conditions at the start of care in labour.

... [T] here was a significant excess of the primary outcome in births planned at home compared with those planned in obstetric units in the restricted group of women without complicating conditions at the start of care in labour.

Not exact matches

«Maternal and newborn outcomes in planned home birth vs planned hospital births: a metaanalysis» by Joseph R. Wax, MD; F. Lee Lucas, PhD; Maryanne Lamont, MLS; Michael G. Pinette, MD; Angelina Cartin; and Jacquelyn Blackstone, DO, appeared in the American Journal of Obstetrics & Gynecology, Volume 203, Issue 3 (September 2010) published by Elsevier.

The rarity of planned home births and particularly perinatal death in any birthing environment makes gathering a sufficient sample for ensuring a dataset large enough to offer the incidences of rare outcomes particularly challenging.

Wax JR, Lucas FL, Lamont M, Pinette MG, Cartin A, Blackstone J. Maternal and newborn outcomes in planned home birth vs planned hospital births: a metaanalysis.

Outcomes of planned home births versus planned hospital births after regulation of midwifery in British Columbia.

Outcomes of planned home births with certified professional midwives: large prospective study in North America.

Hutton EK, Reitsma AH, Kaufman K. Outcomes associated with planned home and planned hospital births in low - risk women attended by midwives in Ontario, Canada, 2003 — 2006: a retrospective cohort study.

Maternal and newborn outcomes in planned home birth vs planned hospital births: a metaanalysis.

Research reveals that there are only 2 acute conditions that might occur at homebirth in which the mother or baby may have a better outcome had they planned a hospital birth, namely: Cord prolapse and Amniotic Fluid Embolism (AFE).

Perinatal mortality rates for hospital births of low risk women are similar to outcomes of planned homebirth in general, but the maternal morbidity at planned hospital births is much higher.

Explain that if they plan birth at home there is a small increase in the risk of an adverse outcome for the baby.

In the latest paper discussed in that post, Severe adverse maternal outcomes among low risk women with planned home versus hospital births in the Netherlands: nationwide cohort study, de Jonge concludeIn the latest paper discussed in that post, Severe adverse maternal outcomes among low risk women with planned home versus hospital births in the Netherlands: nationwide cohort study, de Jonge concludein that post, Severe adverse maternal outcomes among low risk women with planned home versus hospital births in the Netherlands: nationwide cohort study, de Jonge concludein the Netherlands: nationwide cohort study, de Jonge concluded:

Advise low ‑ risk nulliparous women that planning to give birth in a midwifery ‑ led unit (freestanding or alongside) is particularly suitable for them because the rate of interventions is lower and the outcome for the baby is no different compared with an obstetric unit.

1.1.2 Explain to both multiparous and nulliparous women that they may choose any birth setting (home, freestanding midwifery unit, alongside midwifery unit or obstetric unit), and support them in their choice of setting wherever they choose to give birth: Advise low ‑ risk multiparous women that planning to give birth at home or in a midwifery ‑ led unit (freestanding or alongside) is particularly suitable for them because the rate of interventions is lower and the outcome for the baby is no different compared with an obstetric unit.

Quote from the midwife site:» There was no evidence that planned home birth among low risk women leads to an increased risk of severe adverse maternal outcomes in a maternity care system with well trained midwives and a good referral and transportation system.»

Study results provide evidence that mortality outcomes in planned home birth are not significantly different compared to planned hospital birth, among 693,592 women with singleton births in the Netherlands.

Women who planned a home birth were at reduced risk of all obstetric interventions assessed and were at similar or reduced risk of adverse maternal outcomes compared with women who planned to give birth in hospital accompanied by a midwife or physician.

Her latest effort is Severe adverse maternal outcomes among low risk women with planned home versus hospital births in the Netherlands: nationwide cohort study.

If so, this self selection may have resulted in better outcomes among women with planned home birth.

Overall, there were no significant differences in the odds of the primary outcome for births planned in any of the non-obstetric unit settings compared with planned births in obstetric units (table 3 ⇑).

For healthy nulliparous women with a low risk pregnancy, the risk of an adverse perinatal outcome seems to be higher for planned births at home, and the intrapartum transfer rate is high in all settings other than an obstetric unit

For the restricted sample of women without any complicating conditions at the start of care in labour, the odds of a primary outcome event were higher for births planned at home compared with planned obstetric unit births (adjusted odds ratio 1.59, 95 % confidence interval 1.01 to 2.52) but there was no evidence of a difference for either freestanding or alongside midwifery units compared with obstetric units.

Objective To compare perinatal outcomes, maternal outcomes, and interventions in labour by planned place of birth at the start of care in labour for women with low risk pregnancies.

Women planning birth in a midwifery unit and multiparous women planning birth at home experience fewer interventions than those planning birth in an obstetric unit with no impact on perinatal outcomes.

For multiparous women there was no evidence of a difference in the primary outcome by planned place of birth.

For healthy multiparous women with a low risk pregnancy, there are no differences in adverse perinatal outcomes between planned births at home or in a midwifery unit compared with planned births in an obstetric unit

In the subgroup analysis stratified by parity, there was an increased incidence of the primary outcome for nulliparous women in the planned home birth group (weighted incidence 9.3 per 1000 births, 95 % confidence interval 6.5 to 13.1) compared with the obstetric unit group (weighted incidence 5.3, 3.9 to 7.3In the subgroup analysis stratified by parity, there was an increased incidence of the primary outcome for nulliparous women in the planned home birth group (weighted incidence 9.3 per 1000 births, 95 % confidence interval 6.5 to 13.1) compared with the obstetric unit group (weighted incidence 5.3, 3.9 to 7.3in the planned home birth group (weighted incidence 9.3 per 1000 births, 95 % confidence interval 6.5 to 13.1) compared with the obstetric unit group (weighted incidence 5.3, 3.9 to 7.3).

Main outcome measure A composite primary outcome of perinatal mortality and intrapartum related neonatal morbidities (stillbirth after start of care in labour, early neonatal death, neonatal encephalopathy, meconium aspiration syndrome, brachial plexus injury, fractured humerus, or fractured clavicle) was used to compare outcomes by planned place of birth at the start of care in labour (at home, freestanding midwifery units, alongside midwifery units, and obstetric units).

The relative benefits and risks of birth in different settings have been widely debated in recent years.1 2 3 4 5 6 7 A problem when trying to evaluate the effect of birth setting on perinatal outcomes has been the use of actual place of birth rather than planned place of birth to define comparison groups.

When the analysis was restricted to units or trusts with a response rate of at least 85 %, the higher odds of the primary outcome for nulliparous women in the planned home birth group remained, and the strength of this association increased (appendix 5 on bmj.com).

There was no evidence that planned home birth among low risk women leads to an increased risk of severe adverse maternal outcomes in a maternity care system with well trained midwives and a good referral and transportation system.

Adverse perinatal outcomes are uncommon in all settings, while interventions during labour and birth are much less common for births planned in non-obstetric unit settings.

The strengths of the study include the ability to compare outcomes by the woman's planned place of birth at the start of care in labour, the high participation of midwifery units and trusts in England, the large sample size and statistical power to detect clinically important differences in adverse perinatal outcomes, the minimisation of selection bias through achievement of a high response rate and absence of self selection bias due to non-consent, the ability to compare groups that were similar in terms of identified clinical risk (according to current clinical guidelines) and to further increase the comparability of the groups by conducting an additional analysis restricted to women with no complicating conditions identified at the start of care in labour, and the ability to control for several important potential confounders.

There can still be trauma when a planned natural birth ends up in the operating room or outcome is devastating.

The aim of our study was to determine firstly, whether a retrospective linked data study was a viable alternative to such a design using routinely collected data in one Australian state and secondly, to report on the outcomes and interventions for women (and their babies) who planned to give birth in a hospital labour ward, birth centre or at home.

Beat in mind that mothers who plan to give birth in water often feel like stepping out of the birthing pool at the last minute to give birth, so one can never predict the outcome.

«Kenneth C Johnson and Betty - Anne Daviss's Outcomes of planned home births with certified professional midwives: large prospective study in North America, BMJ 2005; 330:1416 (18 June), found that the outcomes of planned homebirths for low risk mothers were the same as the outcomes of planned hospital births for low risk mothers, with a significantly lower incident of interventions in the homebirth groupOutcomes of planned home births with certified professional midwives: large prospective study in North America, BMJ 2005; 330:1416 (18 June), found that the outcomes of planned homebirths for low risk mothers were the same as the outcomes of planned hospital births for low risk mothers, with a significantly lower incident of interventions in the homebirth groupoutcomes of planned homebirths for low risk mothers were the same as the outcomes of planned hospital births for low risk mothers, with a significantly lower incident of interventions in the homebirth groupoutcomes of planned hospital births for low risk mothers, with a significantly lower incident of interventions in the homebirth group.»

A study published in the British Medical Journal (July 2005) of the outcomes of 5,418 planned home births concluded that homebirth is a reasonable and safe choice for healthy women.

The second paper is Selected perinatal outcomes associated with planned home births in the United States by Cheng et al..

The most recent large scale study comparing outcomes for mother and baby reported in the British Medical Journal last month showed that for women who had previously given birth, adverse outcomes were less common among planned home births (1 per 1,000) than among planned hospital births (2.3 per 1,000).

When this 20 % risk of death is compared to the 0.02 % rate of cord prolapse during labor at homebirth that might have a better outcome if it happened in hospital, this means that a low risk woman has a 1000 times higher chance of having a life threatening complication either to her life or her fetus / newborns life at planned hospital birth, than if she plans to have an attended homebirth with a well - trained practitioner.

Oregon now has the most complete, accurate data of any US state on outcomes of births planned to occur in the mother's home or an out - of - hospital birth center.

The study reviewed the births of nearly 17,000 women and found that, among low - risk women, planned home births result in low rates of birth interventions without an increase in adverse outcomes for mothers and newborns.

We categorized out - of - hospital and in - hospital births in Oregon according to the intended place of delivery and in comparing outcomes found that the risks for some adverse neonatal outcomes were increased among planned out - of - hospital births.

In many previous U.S. studies, it was not possible to disaggregate planned in - hospital births from planned out - of - hospital births that took place in the hospital after a woman's intrapartum transfer to the hospital.3, 9,10 The latter births represent 16.5 % of planned out - of - hospital births in our population, and misclassification of these births as in - hospital births caused rates of adverse outcomes among planned out - of - hospital births to be underestimated (in some cases, substantiallyIn many previous U.S. studies, it was not possible to disaggregate planned in - hospital births from planned out - of - hospital births that took place in the hospital after a woman's intrapartum transfer to the hospital.3, 9,10 The latter births represent 16.5 % of planned out - of - hospital births in our population, and misclassification of these births as in - hospital births caused rates of adverse outcomes among planned out - of - hospital births to be underestimated (in some cases, substantiallyin - hospital births from planned out - of - hospital births that took place in the hospital after a woman's intrapartum transfer to the hospital.3, 9,10 The latter births represent 16.5 % of planned out - of - hospital births in our population, and misclassification of these births as in - hospital births caused rates of adverse outcomes among planned out - of - hospital births to be underestimated (in some cases, substantiallyin the hospital after a woman's intrapartum transfer to the hospital.3, 9,10 The latter births represent 16.5 % of planned out - of - hospital births in our population, and misclassification of these births as in - hospital births caused rates of adverse outcomes among planned out - of - hospital births to be underestimated (in some cases, substantiallyin our population, and misclassification of these births as in - hospital births caused rates of adverse outcomes among planned out - of - hospital births to be underestimated (in some cases, substantiallyin - hospital births caused rates of adverse outcomes among planned out - of - hospital births to be underestimated (in some cases, substantiallyin some cases, substantially).

Rates of obstetrical intervention are high in U.S. hospitals, and we found large absolute differences in the risks of these interventions between planned out - of - hospital births and in - hospital births.38 In contrast, serious adverse fetal and neonatal outcomes are infrequent in all the birth settings we assessed, and the absolute differences in risk that we observed between planned birth locations were correspondingly small; for example, planned out - of - hospital births were associated with an excess of less than 1 fetal death per 1000 deliveries in multivariate and propensity - score - adjusted analysein U.S. hospitals, and we found large absolute differences in the risks of these interventions between planned out - of - hospital births and in - hospital births.38 In contrast, serious adverse fetal and neonatal outcomes are infrequent in all the birth settings we assessed, and the absolute differences in risk that we observed between planned birth locations were correspondingly small; for example, planned out - of - hospital births were associated with an excess of less than 1 fetal death per 1000 deliveries in multivariate and propensity - score - adjusted analysein the risks of these interventions between planned out - of - hospital births and in - hospital births.38 In contrast, serious adverse fetal and neonatal outcomes are infrequent in all the birth settings we assessed, and the absolute differences in risk that we observed between planned birth locations were correspondingly small; for example, planned out - of - hospital births were associated with an excess of less than 1 fetal death per 1000 deliveries in multivariate and propensity - score - adjusted analysein - hospital births.38 In contrast, serious adverse fetal and neonatal outcomes are infrequent in all the birth settings we assessed, and the absolute differences in risk that we observed between planned birth locations were correspondingly small; for example, planned out - of - hospital births were associated with an excess of less than 1 fetal death per 1000 deliveries in multivariate and propensity - score - adjusted analyseIn contrast, serious adverse fetal and neonatal outcomes are infrequent in all the birth settings we assessed, and the absolute differences in risk that we observed between planned birth locations were correspondingly small; for example, planned out - of - hospital births were associated with an excess of less than 1 fetal death per 1000 deliveries in multivariate and propensity - score - adjusted analysein all the birth settings we assessed, and the absolute differences in risk that we observed between planned birth locations were correspondingly small; for example, planned out - of - hospital births were associated with an excess of less than 1 fetal death per 1000 deliveries in multivariate and propensity - score - adjusted analysein risk that we observed between planned birth locations were correspondingly small; for example, planned out - of - hospital births were associated with an excess of less than 1 fetal death per 1000 deliveries in multivariate and propensity - score - adjusted analysein multivariate and propensity - score - adjusted analyses.

de Jonge A, Mesman JA, Manniën J, Zwart JJ, van Dillen J, van Roosmalen J. Severe adverse maternal outcomes among low risk women with planned home versus hospital births in the Netherlands: nationwide cohort study.

For example, the fact that 27 transfer patients are listed as having a physician as their planned birth attendant is most likely due to errors in birth - certificate completion; data are currently lacking to inform the degree of misclassification related to this and others factors that affect the study outcomes.

To assess the robustness of the results of our regression analysis, we performed covariate adjustment with derived propensity scores to calculate the absolute risk difference (details are provided in the Supplementary Appendix, available with the full text of this article at NEJM.org).14, 15 To calculate the adjusted absolute risk difference, we used predictive margins and G - computation (i.e., regression - model — based outcome prediction in both exposure settings: planned in - hospital and planned out - of - hospital birth).16, 17 Finally, we conducted post hoc analyses to assess associations between planned out - of - hospital birth and outcomes (cesarean delivery and a composite of perinatal morbidity and mortality), which were stratified according to parity, maternal age, maternal education, and risk level.