Relative risk of postpartum haemorrhage in planned home birth, compared with planned hospital birth: Results of an observational study of over 500,000 maternities in the UK


Nove, Andrea, Berrington, Ann and Matthews, Zoë (2012) Relative risk of postpartum haemorrhage in planned home birth, compared with planned hospital birth: Results of an observational study of over 500,000 maternities in the UK. BMC Pregnancy & Childbirth, 12, (1), 130. (doi:10.1186/1471-2393-12-130). (PMID:23157856).

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Description/Abstract

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.

Item Type: Article
ISSNs: 1471-2393 (electronic)
Subjects: G Geography. Anthropology. Recreation > G Geography (General)
H Social Sciences > HA Statistics
R Medicine > RG Gynecology and obstetrics
Divisions: Faculty of Social and Human Sciences > Social Sciences > Social Statistics & Demography
Faculty of Social and Human Sciences > Southampton Statistical Sciences Research Institute
ePrint ID: 344819
Date Deposited: 05 Nov 2012 12:09
Last Modified: 28 Mar 2014 15:21
Research Funder: ESRC
Projects:
Centre for Population Change: Understanding Population Change in the 21st Century
Funded by: ESRC (RES-625-28-0001)
Led by: Jane Cecelia Falkingham
1 January 2009 to 31 December 2013
URI: http://eprints.soton.ac.uk/id/eprint/344819

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