Reproductive Statistics Branch, Division of Vital Statistics, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland 20782, USA.
Birth. 2011 Mar;38(1):17-23. doi: 10.1111/j.1523-536X.2010.00444.x. Epub 2011 Jan 4.
After a gradual decline from 1990 to 2004, the percentage of births occurring at home in the United States increased by 5 percent in 2005 and that increase was sustained in 2006. The purpose of the study was to analyze trends and characteristics in home births in United States by race and ethnicity from 1990 to 2006.
U.S. birth certificate data on home births were analyzed and compared with hospital births for a variety of demographic and medical characteristics.
From 1990 to 2006, both the number and percentage of home births increased for non-Hispanic white women, but declined for all other race and ethnic groups. In 2006, non-Hispanic white women were three to four times more likely to have a home birth than women of other race and ethnic groups. Home births were more likely than hospital births to occur to older, married women with singleton pregnancies and several previous children. For non-Hispanic white women, fewer home births than hospital births were born preterm, whereas for other race and ethnic groups a higher percentage of home births than hospital births were born preterm. For non-Hispanic white women, two-thirds of home births were delivered by midwives. In contrast, for other race and ethnic groups, most home births were delivered by either physicians or "other" attendants, suggesting that a higher proportion of these births may be unplanned home births because of emergency situations.
Differences in the risk profile of home births by race and ethnicity are consistent with previous research, suggesting that, compared with non-Hispanic white women, a larger proportion of non-Hispanic black and Hispanic home births represent unplanned, emergency situations.
自 1990 年至 2004 年逐渐下降之后，2005 年美国的居家分娩率增长了 5%，这一增长在 2006 年得以持续。本研究旨在分析 1990 年至 2006 年美国不同种族和族裔群体的居家分娩趋势和特征。
分析了美国分娩登记处关于居家分娩的数据，并与医院分娩的数据进行了比较，比较内容包括各种人口统计学和医学特征。
自 1990 年至 2006 年，非西班牙裔白人女性的居家分娩数量和比例均有所增加，但所有其他种族和族裔群体的这两项数据均有所下降。2006 年，非西班牙裔白人女性居家分娩的可能性是其他种族和族裔群体女性的三到四倍。与医院分娩相比，居家分娩更有可能发生在年龄较大、已婚、怀有单胎且有几个孩子的女性身上。对于非西班牙裔白人女性来说，与医院分娩相比，较少的居家分娩为早产分娩，而对于其他种族和族裔群体来说，较高比例的居家分娩为早产分娩。对于非西班牙裔白人女性，三分之二的居家分娩由助产士接生。相比之下，对于其他种族和族裔群体，大多数居家分娩由医生或“其他”接生员接生，这表明这些分娩中有更高的比例可能是由于紧急情况而未计划的居家分娩。
不同种族和族裔群体的居家分娩风险特征存在差异，这与之前的研究结果一致，表明与非西班牙裔白人女性相比，更大比例的非西班牙裔黑人及西班牙裔女性的居家分娩是未计划的紧急情况。
