Comparing the odds of postpartum haemorrhage in planned home birth against planned hospital birth: results of an observational study of over 500,000 maternities in the UK

BMC Pregnancy and Childbirth

Zoë Matthews¹  Ann Berrington²  Andrea Nove³ 

[1] Centre for Global Health, Population and Poverty, University of Southampton, Southampton, England;Southampton Statistical Sciences Research Institute and ESRC Centre for Population Change, University of Southampton, Southampton, England;Division of Social Statistics, University of Southampton, Southampton, England

关键词: Hospital birth;    Postpartum haemorrhage;    Safety;    Home birth;   

Others  :  1151893
DOI  :  10.1186/1471-2393-12-130

 received in 2012-01-15, accepted in 2012-09-21,  发布年份 2012

【 摘 要 】

Background

The aim of this study is to compare the odds of postpartum haemorrhage among women who opt for home birth against the odds of postpartum haemorrhage for those who plan a hospital birth. It is an observational study involving secondary analysis of maternity records, using binary logistic regression modelling. The data relate to pregnancies that received maternity care from one of fifteen hospitals in the former North West Thames Regional Health Authority Area in England, and which resulted in a live or stillbirth in the years 1988–2000 inclusive, excluding ‘high-risk’ pregnancies, unplanned home births, pre-term births, elective Caesareans and medical inductions.

Results

Even after adjustment for known confounders such as parity, the odds of postpartum haemorrhage (≥1000ml of blood lost) are significantly higher if a hospital birth is intended than if a home birth is intended (odds ratio 2.5, 95% confidence interval 1.7 to 3.8). The ‘home birth’ group included women who were transferred to hospital during labour or shortly after birth.

Conclusions

Women and their partners should be advised that the risk of PPH is higher among births planned to take place in hospital compared to births planned to take place at home, but that further research is needed to understand (a) whether the same pattern applies to the more life-threatening categories of PPH, and (b) why hospital birth is associated with increased odds of PPH. If it is due to the way in which labour is managed in hospital, changes should be made to practices which compromise the safety of labouring women.

【 授权许可】

   
2012 Nove et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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