Abstract:
BACKGROUND:Planned home births have leveled off in the United States in recent years after a significant rise starting in the mid-2000s. Planned home births in the United States are associated with increased patient-risk profiles. Multiple studies concluded that, compared with hospital births, absolute and relative risks of perinatal mortality and morbidity in US planned home births are significantly increased. OBJECTIVE:To explore the safety of birth in the United States by comparing the neonatal mortality outcomes of 2 locations, hospital birth and home birth, by 4 types of attendants: hospital midwife; certified nurse-midwife at home; direct-entry ("other") midwife at home; and attendant at home not identified, using the most recent US Centers for Disease Control and Prevention natality data on neonatal mortality for planned home births in the United States. Outcomes are presented as absolute risks (neonatal mortality per 10,000 live births) and as relative risks of neonatal mortality (hospital-certified nurse-midwife odds ratio, 1) overall, and for recognized risk factors. STUDY DESIGN:We used the most current US Centers for Disease and Prevention Control Linked Birth and Infant Death Records for 2010-2017 to assess neonatal mortality (neonatal death days 0-27 after birth) for single, term (37+ weeks), normal-weight ( >2499 g) infants for planned home births and hospital births by birth attendants: hospital-certified nurse-midwives, home-certified nurse-midwives, home other midwives (eg, lay or direct-entry midwives), and other home birth attendant not identified. RESULTS:The neonatal mortality for US hospital midwife-attended births was 3.27 per 10,000 live births, 13.66 per 10,000 live births for all planned home births, and 27.98 per 10,000 live births for unintended/unplanned home births. Planned home births attended by direct-entry midwives and by certified nurse-midwives had a significantly elevated absolute and relative neonatal mortality risk compared with certified nurse-midwife-attended hospital births (hospital-certified nurse-midwife: 3.27/10,000 live births odds ratio, 1; home birth direct-entry midwives: neonatal mortality 12.44/10,000 live births, odds ratio, 3.81, 95% confidence interval, 3.12-4.65, P<.0001; home birth-certified nurse-midwife: neonatal mortality 9.48/10,000 live births, odds ratio, 2.90, 95% confidence interval, 2.90; P<.0001). These differences increased further when patients were stratified for recognized risk factors. CONCLUSION:The safety of birth in the United States varies by location and attendant. Compared with US hospital births attended by a certified nurse-midwife, planned US home births for all types of attendants are a less safe setting of birth, especially when recognized risk factors are taken into account. The type of midwife attending US planned home birth appears to have no differential effect on decreasing the absolute and relative risk of neonatal mortality of planned home birth, because the difference in outcomes of US planned home births attended by direct-entry midwives or by certified nurse-midwives is not statistically significant.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Grünebaum A,McCullough LB,Orosz B,Chervenak FAdoi
10.1016/j.ajog.2020.01.045subject
Has Abstractpub_date
2020-08-01 00:00:00pages
254.e1-254.e8issue
2eissn
0002-9378issn
1097-6868pii
S0002-9378(20)30067-3journal_volume
223pub_type
杂志文章abstract:OBJECTIVE:The purpose of this study was to determine whether a wet mount preparation of endocervical secretions from obstetric patients can accurately rule out the presence of gonococci and Chlamydia trachomatis. STUDY DESIGN:Gravid patients were screened for gonococci and C trachomatis with a deoxyribonucleic acid pr...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(99)70549-1
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate the antenatal umbilical cord coiling index obtained during the fetal anatomic survey in the second trimester as a predictor of adverse pregnancy outcome. STUDY DESIGN:Four hundred twenty-five consecutive women who had a fetal anatomic survey between 18 to 23 weeks of...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.12.092
更新日期:2005-08-01 00:00:00
abstract::A retrospective chart review was performed on all patients undergoing trachelectomy in the Roanoke Valley between January 1, 1975 and April 30, 1987. During this period a total of 55 trachelectomies were performed. Fifty-three of the 55 trachelectomies (96%) were performed by the vaginal approach. Forty-seven of the 5...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(88)80042-5
更新日期:1988-09-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to assess the feasibility of using infrared spectroscopy to simultaneously predict preterm infection, fetal distress, and fetal lung maturity. STUDY DESIGN:A total of 189 infrared spectra were acquired from amniotic fluid obtained by amniocentesis. The concentrations of glucose ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(99)70275-9
更新日期:1999-03-01 00:00:00
abstract:OBJECTIVE:Our purpose was to examine the indications for performing cesarean sections in current obstetric practice and to define and measure the true contribution of dystocia ("difficult labor") to the overall cesarean section rate. STUDY DESIGN:A prospective audit was done of all cesarean sections performed during 1...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(94)70080-x
更新日期:1994-07-01 00:00:00
abstract::In order to examine the relationship between circadian rhythms in different steroids, cortisol (F), estrone E1), estradiol (E2), and estriol (E3) were measured by radioimmunoassay in maternal venous plasma taken at 30 to 60-minute intervals over 24 hours from 11 healthy women at 34 to 35 weeks' gestation. Maternal F w...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(79)90393-4
更新日期:1979-11-15 00:00:00
abstract:OBJECTIVE:Our purpose was to determine the effect of perfusate flow or viscosity on release and action of nitric oxide in the human fetal-placental vasculature in vitro. STUDY DESIGN:Cotyledons from normal term placentas were perfused with Hanks' buffered saline solution gassed with 95% oxygen and 5% carbon dioxide, p...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(95)90327-5
更新日期:1995-09-01 00:00:00
abstract:OBJECTIVE:The study aims to investigate the prevalence of maternity blues and examine the risk factors involved in a group of Nigerian postpartum women. STUDY DESIGN:Five hundred and two postpartum women who had a normal vaginal delivery in 5 health centers in Ilesa Township were assessed with the Maternity Blues Scal...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajog.2005.02.085
更新日期:2005-10-01 00:00:00
abstract::Follicular fluid samples were obtained by puncturing follicles of ovaries in situ from patients undergoing laparotomy. Sodium, potassium, chloride, magnesium, calcium, phosphorus, and sulfur concentrations measured by electron probe microanalysis were similar to those of blood, with minimal differences. This suggested...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(77)90690-1
更新日期:1977-05-15 00:00:00
abstract::The kinetics of prostaglandins instilled vaginally has been studied in the maternal and fetal circulations, with observation of changes in the stable prostaglandin E2 metabolite 11-deoxy-13,14-dihydro-15-keto-11 beta,16-cyclo-prostaglandin E2. After the administration of prostaglandin E2, 10 mg in a wax-based pessary,...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(89)90752-7
更新日期:1989-10-01 00:00:00
abstract:OBJECTIVE:Our purpose was to evaluate in a sheep model for endoscopic fetal surgery the impact of nitrous oxide-gas amniodistention compared with fluid amniodistention on duration of surgery, hemorrhagic events, and fetomaternal acid-base status. STUDY DESIGN:Pregnant ewes (n = 16) at 92 to 104 days of gestation (term...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2002.120482
更新日期:2002-03-01 00:00:00
abstract:OBJECTIVE:We sought to determine if genetic polymorphisms in the aryl hydrocarbon receptor signaling pathway are associated with menopausal hot flashes via hormone levels. STUDY DESIGN:Women (n = 639) aged 45-54 years completed a study survey and provided blood for genetic and hormone analyses. The associations were a...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2012.05.019
更新日期:2012-09-01 00:00:00
abstract::Despite current recommendations against its use, activity restriction remains a common intervention used to prevent preterm birth in multiple clinical settings. Hypertensive disorders of pregnancy, preterm premature rupture of membranes, multiple gestations, vaginal bleeding, short cervical length, placenta previa, an...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,实务指引
doi:10.1016/j.ajog.2020.04.031
更新日期:2020-08-01 00:00:00
abstract::To determine the role of carbon dioxide in the generation of fetal respiratory movements, the effect of induced maternal hypocapnia and hypercapnia on fetal breathing movements, gross body movements, and fetal heart rate was studied in 12 healthy pregnant women near term. Patients were studied for a 1-hour control per...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-9378(88)90147-0
更新日期:1988-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to evaluate perinatal outcome after thoracoamniotic shunting for fetal pleural effusions with hydrops. STUDY DESIGN:This was a retrospective study. RESULTS:Shunting was performed immediately after diagnosis and was successful in all 54 of the cases that were attempted. There we...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2004.05.016
更新日期:2004-12-01 00:00:00
abstract:OBJECTIVE:We studied ovarian cancers for the expression of membrane markers of hematopoietic origin. STUDY DESIGN:We used flow cytometry to systematically characterize the expression of more than 30 hematologic antigens on ovarian carcinoma cell lines and to assess their stability under estrogen exposure. The expressi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2009.05.013
更新日期:2009-08-01 00:00:00
abstract::We describe a patient who had abnormal sonographic findings of the liver 24 hours before signs and symptoms of severe preeclampsia and HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count). The abnormal sonographic appearance of the liver prompted further investigation and was instrumental in the ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(85)80047-8
更新日期:1985-07-15 00:00:00
abstract::Between October, 1969, and April, 1981, gynecologic oncologists at the University of Alabama Medical Center in Birmingham have performed 119 pelvic exenterations. One hundred fifteen of these patients had a concurrent supravesical urinary diversion. Fifty-six patients (48.7%) had an anterior exenteration and 59 patien...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(16)32536-4
更新日期:1982-04-01 00:00:00
abstract::It has been suggested that continued diffusion gradients from mother to fetus would exist and that both meperidine and normeperidine would accumulate in the fetus following multiple doses of meperidine to the mother during labor. However, no pharmacokinetic data are available. Therefore, the purpose of this study was ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90314-x
更新日期:1985-02-01 00:00:00
abstract::In 10 healthy women near term, fetal heart rate, as monitored from an abdominal electrocardiogram, and its variation were analyzed over 24 hours. During the daytime, this was combined with real-time scanning for fetal breathing and movements. There was an episodic change in high and low pulse (R-R) interval variation ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(82)90757-8
更新日期:1982-03-01 00:00:00
abstract::Prostaglandin E2 is a powerful oxytocic agent that reliably initiates labor, even in the presence of an unripe cervix. The low incidence of fetomaternal complication contributes to its universal use. We report a rare case of uterine rupture after intracervical application of prostaglandin E2 gel. Thus far no prostagla...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90094-8
更新日期:1991-08-01 00:00:00
abstract::Repeated use of a long-acting sympathomimetic amine in the form of a nasal spray was associated with a nonreactive nonstress test and late decelerations in a patient at 41 weeks of gestation. Six hours after the last dose, these changes gradually disappeared. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(85)90351-5
更新日期:1985-12-01 00:00:00
abstract::A review of 80 cases of planned or anticipated cesarean hysterectomies done at major centers in the greater Los Angeles area is presented. There were no deaths and five cases of morbidity. Nineteen percent, or one of five cases, required blood transfusions. According to the recommendation of the American Association o...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(84)90287-4
更新日期:1984-05-01 00:00:00
abstract:BACKGROUND:While research has demonstrated increasing risk for severe maternal morbidity in the United States, risk at lower volume hospitals remains poorly characterized. More than half of all obstetric units in the United States perform <1000 deliveries per year and improving care at these hospitals may be critical t...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2016.10.029
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVE:This study investigates the association of allelic variation in angiogenic pathway genes and preeclampsia. STUDY DESIGN:Data for cases with preeclampsia and term control subjects were collected prospectively. Maternal DNA was extracted, and 124 tagging single nucleotide polymorphisms in 6 genes (vascular end...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2010.01.040
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:We compared localization of human immunodeficiency virus type 1 within human placentas infected in utero with localization within human placental explants infected in vitro. STUDY DESIGN:Placental tissues from 3 cases of vertical transmission of human immunodeficiency virus type 1 were studied. Human placent...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(00)70514-x
更新日期:2000-01-01 00:00:00
abstract::Recently, vasoactive intestinal polypeptide (VIP) has been localized in nerve fibers in the human female genital tract. In the present investigation, the effect and concentration of VIP was studied in uterine tissue from pregnant and nonpregnant women, and the plasma concentration of VIP was measured in relationship t...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(82)90083-7
更新日期:1982-06-15 00:00:00
abstract::Fetal gender was prospectively determined by ultrasonography in 115 patients with singleton pregnancies between 16 and 20 weeks of gestation. Gender determination was performed as a part of the sonographic examination preceding genetic amniocentesis, and the results were compared to the amniotic fluid fetal karyotype ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(87)90055-x
更新日期:1987-03-01 00:00:00
abstract:OBJECTIVE:Our purpose was to learn whether cytokines such as interleukin-1 beta and related (or antagonistic) cytokines, hormones, and growth factors could regulate secretion of the vasorelaxant parathyroid hormone-related protein in human umbilical vein endothelial cells in culture. STUDY DESIGN:Secondary cultures of...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(95)90265-1
更新日期:1995-08-01 00:00:00
abstract:OBJECTIVE:We assessed the screening and remediation of home lead hazards prenatally in a high-risk population, hypothesizing that average blood-lead level and the number of poisonings would drop by 25%. STUDY DESIGN:One hundred fifty-two women underwent prenatal home inspections by certified lead inspectors. The hazar...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2012.01.001
更新日期:2012-03-01 00:00:00