Homer Caroline S E, Thornton Charlene, Scarf Vanessa L, Ellwood David A, Oats Jeremy J N, Foureur Maralyn J, Sibbritt David, McLachlan Helen L, Forster Della A, Dahlen Hannah G
Centre for Midwifery, Child and Family Health, Faculty of Health Level 7, University of Technology, 235-253 Jones St, Broadway, Sydney, New South Wales, Australia.
BMC Pregnancy Childbirth. 2014 Jun 14;14:206. doi: 10.1186/1471-2393-14-206.
The outcomes for women who give birth in hospital compared with at home are the subject of ongoing debate. We aimed to determine whether a retrospective linked data study using routinely collected data was a viable means to compare perinatal and maternal outcomes and interventions in labour by planned place of birth at the onset of labour in one Australian state.
A population-based cohort study was undertaken using routinely collected linked data from the New South Wales Perinatal Data Collection, Admitted Patient Data Collection, Register of Congenital Conditions, Registry of Birth Deaths and Marriages and the Australian Bureau of Statistics. Eight years of data provided a sample size of 258,161 full-term women and their infants. The primary outcome was a composite outcome of neonatal mortality and morbidity as used in the Birthplace in England study.
Women who planned to give birth in a birth centre or at home were significantly more likely to have a normal labour and birth compared with women in the labour ward group. There were no statistically significant differences in stillbirth and early neonatal deaths between the three groups, although we had insufficient statistical power to test reliably for these differences.
This study provides information to assist the development and evaluation of different places of birth across Australia. It is feasible to examine perinatal and maternal outcomes by planned place of birth using routinely collected linked data, although very large data sets will be required to measure rare outcomes associated with place of birth in a low risk population, especially in countries like Australia where homebirth rates are low.
与在家分娩相比，在医院分娩的女性的结局一直是争论的焦点。我们旨在确定一项使用常规收集数据的回顾性关联数据研究是否是比较澳大利亚一个州分娩开始时按计划分娩地点划分的围产期和孕产妇结局及分娩干预措施的可行方法。
采用基于人群的队列研究，使用来自新南威尔士州围产期数据收集、住院患者数据收集、先天性疾病登记册、出生死亡和婚姻登记处以及澳大利亚统计局的常规收集的关联数据。八年的数据提供了258,161名足月妇女及其婴儿的样本量。主要结局是英格兰出生地点研究中使用的新生儿死亡率和发病率的综合结局。
与分娩病房组的女性相比，计划在分娩中心或在家分娩的女性顺产和正常分娩的可能性明显更高。三组之间死产和早期新生儿死亡没有统计学上的显著差异，尽管我们没有足够的统计效力来可靠地检验这些差异。
本研究提供了信息，以协助澳大利亚各地不同分娩地点的发展和评估。使用常规收集的关联数据按计划分娩地点检查围产期和孕产妇结局是可行的，尽管需要非常大的数据集来衡量低风险人群中与分娩地点相关的罕见结局，特别是在像澳大利亚这样家庭分娩率较低的国家。
