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.
Conclusion:
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.
Acknowledgments
The New York City Department of Health and Mental Hygiene, Vital Statistics Office. Sources: New York Presbyterian Hospital, Weill Cornell Medical College; The New York City Department of Health and Mental Hygiene, Vital Statistics.
References
[1] American College of Obstetricans and Gynecologists. Executive summary: neonatal encephalopathy and neurologic outcome, second edition. Report of the American College of Obstetricians and Gynecologists’ Task Force on Neonatal Encephalopathy. Obstet Gynecol. 2014;123:896–901.10.1097/01.AOG.0000445580.65983.d2Search in Google Scholar PubMed
[2] Kurinczuk JJ, White-Koning M, Badawi N. Epidemiology of neonatal encephalopathy and hypoxic-ischaemic encephalopathy. Early Hum Dev. 2010;86:329–38.10.1016/j.earlhumdev.2010.05.010Search in Google Scholar PubMed
[3] Badawi N, Kurinczuk JJ, Keogh JM, Alessandri LM, O’Sullivan F, Burton PR, et al. Antepartum risk factors for newborn encephalopathy: the Western Australian case-control study. Br Med J 1998;317:1549–53.10.1136/bmj.317.7172.1549Search in Google Scholar
[4] Smith J, Wells L, Dodd K. The continuing fall in incidence of hypoxic-ischaemic encephalopathy in term infants. Br J Obstet Gynaecol. 2000;107:461–6.10.1111/j.1471-0528.2000.tb13262.xSearch in Google Scholar
[5] Thornberg E, Thiringer K, Odeback A, Milsom I. Birth asphyxia: incidence, clinical course and outcome in a Swedish population. Acta Paediatr. 1995;84:927–32.10.1111/j.1651-2227.1995.tb13794.xSearch in Google Scholar
[6] Jacobs SE, Berg M, Hunt R, Tarnow-Mordi WO, Inder TE, Davis PG. Cooling for newborns with hypoxic ischaemic encephalopathy. Cochrane Database Syst Rev. 2013;1:Cd003311.10.1002/14651858.CD003311.pub3Search in Google Scholar
[7] Pfister RH, Soll RF. Hypothermia for the treatment of infants with hypoxic-ischemic encephalopathy. J Perinatol. 2010;30(Suppl):S82–7.10.1038/jp.2010.91Search in Google Scholar PubMed
[8] Badawi N, Kurinczuk JJ, Keogh JM, Alessandri LM, O’Sullivan F, Burton PR, et al. Intrapartum risk factors for newborn encephalopathy: the Western Australian case-control study. Br Med J. 1998;317:1554–8.10.1136/bmj.317.7172.1554Search in Google Scholar
[9] Blume HK, Li CI, Loch CM, Koepsell TD. Intrapartum fever and chorioamnionitis as risks for encephalopathy in term newborns: a case-control study. Dev Med Child Neurol. 2008;50:19–24.10.1111/j.1469-8749.2007.02007.xSearch in Google Scholar PubMed
[10] Cowan F, Rutherford M, Groenendaal F, Eken P, Mercuri E, Bydder GM, et al. Origin and timing of brain lesions in term infants with neonatal encephalopathy. Lancet. 2003;361:736–42.10.1016/S0140-6736(03)12658-XSearch in Google Scholar PubMed
[11] Grunebaum A, McCullough LB, Sapra KJ, Brent RL, Levene MI, Arabin B, et al. Apgar score of 0 at 5 minutes and neonatal seizures or serious neurologic dysfunction in relation to birth setting. Am J Obstet Gynecol. 2013;209:323.e1–6.10.1016/j.ajog.2013.06.025Search in Google Scholar PubMed
[12] 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. Am J Obstet Gynecol. 2010 Sep;203:243.e1–8.10.1016/j.ajog.2010.05.028Search in Google Scholar PubMed
[13] Cheng YW, Snowden JM, King TL, Caughey AB. Selected perinatal outcomes associated with planned home births in the United States. Am J Obstet Gynecol 2013;209:325.e1–8.10.1016/j.ajog.2013.06.022Search in Google Scholar PubMed
[14] Snowden JM, Tilden EL, Snyder J, Quigley B, Caughey AB, Cheng YW. Planned out-of-hospital birth and birth outcomes. N Engl J Med. 2015;373:2642–53.10.1056/NEJMsa1501738Search in Google Scholar PubMed PubMed Central
[15] American College of Nurse-Midwives. Position statement on home birth. Washington, DC: ACNM; 2005.Search in Google Scholar
[16] American Public Health Association. Increasing access to out-of-hospital maternity care services through state-regulated and nationally-certified direct-entry midwives. Washington, DC: American Public Health; 2001.Search in Google Scholar
[17] MacDorman MF, Mathews TJ, Declercq E. Home births in the United States, 1990–2009. NCHS Data Brief. 2012;84:1–8.Search in Google Scholar
[18] Grunebaum A, Chervenak FA. Out-of-hospital births in the United States, 2009–2014. J Perinat Med. 2016;44:845–9.10.1515/jpm-2015-0396Search in Google Scholar PubMed
[19] American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 476: planned home birth. Obstet Gynecol. 2011;117(2 Pt 1):425–8.10.1097/AOG.0b013e31820eee20Search in Google Scholar PubMed
[20] American Academy of Pediatrics. Policy statement: planned home birth. Pediatrics. 2013;131:1016.10.1542/peds.2013-0575Search in Google Scholar
The authors stated that there are no conflicts of interest regarding the publication of this article.
Article note:
Presented at the 34th Annual Meeting of the Society for Maternal-Fetal Medicine, February 3–8, 2014, New Orleans, Louisiana.
©2017 Walter de Gruyter GmbH, Berlin/Boston
