Maternal and perinatal outcomes by planned place of birth in Australia 2000 - 2012: A linked population data study

Homer, CSE; Cheah, SL; Rossiter, C; Dahlen, HG; Ellwood, D; Foureur, MJ; Forster, DA; Mclachlan, HL; Oats, JJN; Sibbritt, D; Thornton, C; Scarf, VL

Maternal and perinatal outcomes by planned place of birth in Australia 2000 - 2012: A linked population data study

Homer, CSE

Cheah, SL

Rossiter, C

Dahlen, HG

Ellwood, D

Foureur, MJ

Forster, DA

Mclachlan, HL Oats, JJN

Sibbritt, D

Thornton, C

Scarf, VL

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Publication Type:: Journal Article
Citation:: BMJ Open, 2019, 9 (10)
Issue Date:: 2019-10-01

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Field	Value	Language
dc.contributor.author	Homer, CSE https://orcid.org/0000-0002-7454-3011	en_US
dc.contributor.author	Cheah, SL https://orcid.org/0000-0003-4734-5770	en_US
dc.contributor.author	Rossiter, C https://orcid.org/0000-0002-3833-3076	en_US
dc.contributor.author	Dahlen, HG https://orcid.org/0000-0002-4450-3078	en_US
dc.contributor.author	Ellwood, D https://orcid.org/0000-0003-4512-6443	en_US
dc.contributor.author	Foureur, MJ https://orcid.org/0000-0002-0454-0165	en_US
dc.contributor.author	Forster, DA https://orcid.org/0000-0002-6083-087X	en_US
dc.contributor.author	Mclachlan, HL	en_US
dc.contributor.author	Oats, JJN https://orcid.org/0000-0003-3808-9808	en_US
dc.contributor.author	Sibbritt, D https://orcid.org/0000-0003-3561-9447	en_US
dc.contributor.author	Thornton, C https://orcid.org/0000-0003-4457-1799	en_US
dc.contributor.author	Scarf, VL https://orcid.org/0000-0003-3503-9610	en_US
dc.date.issued	2019-10-01	en_US
dc.identifier.citation	BMJ Open, 2019, 9 (10)	en_US
dc.identifier.uri	http://hdl.handle.net/10453/136749
dc.description.abstract	© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Objective To compare perinatal and maternal outcomes for Australian women with uncomplicated pregnancies according to planned place of birth, that is, in hospital labour wards, birth centres or at home. Design A population-based retrospective design, linking and analysing routinely collected electronic data. Analysis comprised χ 2 tests and binary logistic regression for categorical data, yielding adjusted ORs. Continuous data were analysed using analysis of variance. Setting All eight Australian states and territories. Participants Women with uncomplicated pregnancies who gave birth between 2000 and 2012 to a singleton baby in cephalic presentation at between 37 and 41 completed weeks' gestation. Of the 1 251 420 births, 1 171 703 (93.6%) were planned in hospital labour wards, 71 505 (5.7%) in birth centres and 8212 (0.7%) at home. Main outcome measures Mode of birth, normal labour and birth, interventions and procedures during labour and birth, maternal complications, admission to special care/high dependency or intensive care units (mother or infant) and perinatal mortality (intrapartum stillbirth and neonatal death). Results Compared with planned hospital births, the odds of normal labour and birth were over twice as high in planned birth centre births (adjusted OR (AOR) 2.72; 99% CI 2.63 to 2.81) and nearly six times as high in planned home births (AOR 5.91; 99% CI 5.15 to 6.78). There were no statistically significant differences in the proportion of intrapartum stillbirths, early or late neonatal deaths between the three planned places of birth. Conclusions This is the first Australia-wide study to examine outcomes by planned place of birth. For healthy women in Australia having an uncomplicated pregnancy, planned births in birth centres or at home are associated with positive maternal outcomes although the number of homebirths was small overall. There were no significant differences in the perinatal mortality rate, although the absolute numbers of deaths were very small and therefore firm conclusions cannot be drawn about perinatal mortality outcomes.	en_US
dc.relation.ispartof	BMJ Open	en_US
dc.relation.isbasedon	10.1136/bmjopen-2019-029192	en_US
dc.rights	info:eu-repo/semantics/openAccess
dc.title	Maternal and perinatal outcomes by planned place of birth in Australia 2000 - 2012: A linked population data study	en_US
dc.type	Journal Article
utslib.citation.volume	10	en_US
utslib.citation.volume	9	en_US
utslib.for	1114 Paediatrics and Reproductive Medicine	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	1199 Other Medical and Health Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/IMPACCT
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Midwifery
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Nursing
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney/Strength - WHO CC
utslib.copyright.status	open_access	*
pubs.issue	10	en_US
pubs.publication-status	Published	en_US
pubs.volume	9	en_US

Abstract:

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Objective To compare perinatal and maternal outcomes for Australian women with uncomplicated pregnancies according to planned place of birth, that is, in hospital labour wards, birth centres or at home. Design A population-based retrospective design, linking and analysing routinely collected electronic data. Analysis comprised χ 2 tests and binary logistic regression for categorical data, yielding adjusted ORs. Continuous data were analysed using analysis of variance. Setting All eight Australian states and territories. Participants Women with uncomplicated pregnancies who gave birth between 2000 and 2012 to a singleton baby in cephalic presentation at between 37 and 41 completed weeks' gestation. Of the 1 251 420 births, 1 171 703 (93.6%) were planned in hospital labour wards, 71 505 (5.7%) in birth centres and 8212 (0.7%) at home. Main outcome measures Mode of birth, normal labour and birth, interventions and procedures during labour and birth, maternal complications, admission to special care/high dependency or intensive care units (mother or infant) and perinatal mortality (intrapartum stillbirth and neonatal death). Results Compared with planned hospital births, the odds of normal labour and birth were over twice as high in planned birth centre births (adjusted OR (AOR) 2.72; 99% CI 2.63 to 2.81) and nearly six times as high in planned home births (AOR 5.91; 99% CI 5.15 to 6.78). There were no statistically significant differences in the proportion of intrapartum stillbirths, early or late neonatal deaths between the three planned places of birth. Conclusions This is the first Australia-wide study to examine outcomes by planned place of birth. For healthy women in Australia having an uncomplicated pregnancy, planned births in birth centres or at home are associated with positive maternal outcomes although the number of homebirths was small overall. There were no significant differences in the perinatal mortality rate, although the absolute numbers of deaths were very small and therefore firm conclusions cannot be drawn about perinatal mortality outcomes.

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http://hdl.handle.net/10453/136749