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International data demonstrate home birth safety

International data demonstrate home birth safety To the Editors: The metaanalysis by Wax et al 1 resulted in misleading results and conclusions about the safety of home birth.</P>The authors appropriately found no difference in perinatal mortality rates between planned home and planned hospital births when they included all of the selected studies, which included the very large, high-quality Dutch study that represented >90% of the available data. 2 </P>However, when they summarized the risk for neonatal death separately, they chose to look only at combined early (0-6 days) and late (7-28 days) neonatal deaths. Because the Dutch study reported only on early neonatal deaths, Wax et al excluded it, thus ignoring neonatal mortality rates for 90% of the available home birth data. If early neonatal deaths had been examined separately, the Dutch study would have been included, and the conclusion would have been that the risk of early neonatal death in home births was no different than that for low-risk hospital births.</P>Across perinatal/neonatal studies in high resource countries, 65% to 80% of neonatal deaths consistently occur in the first 7 days. 3 There is no reason to expect that the rate of late neonatal mortality in the Dutch study would carry any difference in http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Obstetrics and Gynecology Wolters Kluwer Health

International data demonstrate home birth safety

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References (6)

Publisher
Wolters Kluwer Health
Copyright
Copyright © 2011 Mosby, Inc.
ISSN
0002-9378
DOI
10.1016/j.ajog.2011.01.034
pmid
21458614
Publisher site
See Article on Publisher Site

Abstract

To the Editors: The metaanalysis by Wax et al 1 resulted in misleading results and conclusions about the safety of home birth.</P>The authors appropriately found no difference in perinatal mortality rates between planned home and planned hospital births when they included all of the selected studies, which included the very large, high-quality Dutch study that represented >90% of the available data. 2 </P>However, when they summarized the risk for neonatal death separately, they chose to look only at combined early (0-6 days) and late (7-28 days) neonatal deaths. Because the Dutch study reported only on early neonatal deaths, Wax et al excluded it, thus ignoring neonatal mortality rates for 90% of the available home birth data. If early neonatal deaths had been examined separately, the Dutch study would have been included, and the conclusion would have been that the risk of early neonatal death in home births was no different than that for low-risk hospital births.</P>Across perinatal/neonatal studies in high resource countries, 65% to 80% of neonatal deaths consistently occur in the first 7 days. 3 There is no reason to expect that the rate of late neonatal mortality in the Dutch study would carry any difference in

Journal

American Journal of Obstetrics and Gynecology – Wolters Kluwer Health

Published: Apr 1, 2011

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