ACOG: Perinatal Mortality Higher in Out-of-Hospital Births

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‘Breech presentation, pregnancy-induced

hypertension or preeclampsia, and postdates gestation were high-risk conditions

associated with the other seven deaths.’

s. fuchs dc

ACOG:

Perinatal Mortality Higher in Out-of-Hospital Births

Last Updated: May 08, 2012.

Five-yea retrospective analysis shows higher death rates for

out-of-hospital births in Oregon

The incidence of perinatal mortality appears to be

higher in out-of-hospital births, according to a study conducted in Oregon and presented at the annual clinical meeting of

the American College

of Obstetricians and Gynecologists, held from May 5 to 9 in San Diego.

TUESDAY,

May 8 (HealthDay News) -- The incidence of perinatal mortality appears to be

higher in out-of-hospital births, according to a study conducted in Oregon

and presented at the annual clinical meeting of the American College of

Obstetricians and Gynecologists, held from May 5 to 9 in San Diego.

Lani

Doser, M.N., from the Oregon Health & Science University in Portland, and

colleagues conducted a five-year (2004 through 2008) retrospective study to

investigate the maternal and neonatal outcomes of 229 cases transferred to an

Oregon tertiary care referral center during planned home or birth-center

births.

Of the

223 cases with recorded neonatal outcomes, the researchers noted eight

deaths; seven of which met the perinatal mortality definition 1 (PMD1) (death

between 28 weeks of gestation and seven days of life) and one of which died

after seven days of life. Among cases transferred to the study hospital,

there was a PMD1 of 31 per 1,000 for planned out-of-hospital births. One of

the eight infants who died had congenital anomalies not compatible with life.

Breech presentation, pregnancy-induced hypertension or preeclampsia, and

postdates gestation were high-risk conditions associated with the other seven

deaths. A licensed direct entry midwife cared for seven of the cases, and an

unlicensed midwife cared for the case with congenital anomalies.

" Our

findings suggest that more research is needed to assess the maternal/fetal

risk factors or provider-related factors that may have contributed to the

higher incidence of perinatal mortality, " the authors conclude.

Abstract

No. 51

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