Welffens K, Kirkpatrick C, Daelemans C, Derisbourg S
Service d'Obstétrique, Hôpital Erasme, Route de Lennik 808, Bruxelles, Belgium.
Rev Med Brux. 2016;37(4):261-268.
In Belgium, very few women give birth outside the delivery room. In the United Kingdom and in the Netherlands, they are more numerous. Several studies evaluated obstetric and neonatal outcomes of home births compared with hospital births. We selected seven recent and large studies (with cohorts of more than 5.000 women) using PubMed, Science Direct and Cochrane Database of Systematic Reviews. Several questions were examined. Is there any difference in maternal and neonatal outcomes depending on the intended place of birth? Does parity affect outcomes ? What are the characteristics of women who choose to deliver at home ? We conclude that giving birth at home improves obstetric outcomes but is riskier for the baby, especially for the first one. The women delivering at home are mainly white Europeans, between 25 and 35 years old, in a relationship, multiparous and wealthier. In order to avoid this increased risk for the baby while preserving the obstetric advantages, alongside birth centers offer an intermediate solution. They combine the reassuring home-like atmosphere with the safety of the hospital. In Belgium, the first alongside birth center " Le Cocon " (a low technicity unit distinct from the delivery room) offers now this type of alternative place of birth for women in Hôpital Erasme in Brussels.
在比利时,很少有女性在产房外分娩。在英国和荷兰,在产房外分娩的女性较多。几项研究评估了在家分娩与在医院分娩相比的产科和新生儿结局。我们使用PubMed、科学Direct和Cochrane系统评价数据库筛选了七项近期的大型研究(队列中有超过5000名女性)。研究了几个问题。根据预期的分娩地点,母婴结局是否存在差异?产次是否会影响结局?选择在家分娩的女性有哪些特征?我们得出结论,在家分娩可改善产科结局,但对婴儿来说风险更高,尤其是头胎。在家分娩的女性主要是欧洲白人,年龄在25至35岁之间,处于恋爱关系中,经产妇且较为富有。为了在保留产科优势的同时避免婴儿面临这种增加的风险, alongside birth centers提供了一种中间解决方案。它们将令人安心的家庭般氛围与医院的安全性结合起来。在比利时,首个alongside birth center “Le Cocon”(一个与产房不同的低技术含量单元)现在为布鲁塞尔伊拉斯谟医院的女性提供这种替代分娩地点。