[Birthplace free-standing birth center -- perinatal data in comparison with clinic deliveries in Bavaria and Berlin].

QUESTION

The purpose of this investigation is to find any differences between important maternal and infantile perinatal data from a clinic and a birth center group. Is the perinatal and/or maternal mortality in the birth center group higher? What influence do different socioeconomic factors have on the clinic group?

PATIENTS AND METHODS

We have carried out a retrospective comparison of the obstetric parameters from all birth center deliveries in the states Berlin and Bavaria for the years 1999 and 2000 (n = 3,060) and the perinatal data investigations of selected clinical groups of both states (n = 55,875).

RESULTS

Objective parameters in both groups regarding week of potation at delivery, parity, age of pregnant women, infantile measures, primi- and multiparae and Apgar scales were comparable. There are significant differences in the delivery mode (spontaneous deliveries: birth centers > clinics; operative deliveries: birth centers < clinics), in blood loss over 1,000 ml (birth centers > clinics), in the episiotomy and perineal tear rate (birth centers < clinics), in the infantile transfer rate to a neonatology unit (birth centers < clinics) and in the frequency of necessary neonatological measures in the neonate (birth centers > clinics). The perinatal and maternal mortality in the groups were similar. Within the clinical group the socioeconomic status and a background of immigration had no significant influence on the perinatal data.

CONCLUSION

The retrospective data show that the more "invasive" clinical obstetrics leads to a similar postnatal condition of the neonates in comparison to the birth house group. Further comparative studies over several years are necessary to make statements about the occurrence of rare risks and maternal mortality in the free-standing birth center groups.