低风险妊娠中计划在家分娩与计划在医院分娩的结局：荷兰助产实践的前瞻性研究
Outcome of planned home and planned hospital births in low risk pregnancies: prospective study in midwifery practices in The Netherlands.
作者信息
Wiegers T A, Keirse M J, van der Zee J, Berghs G A
机构信息
NIVEL (Netherlands Institute of Primary Health Care), Utrecht, Netherlands.
出版信息
BMJ. 1996 Nov 23;313(7068):1309-13. doi: 10.1136/bmj.313.7068.1309.
OBJECTIVE
To investigate the relation between the intended place of birth (home or hospital) and perinatal outcome in women with low risk pregnancies after controlling for parity and social, medical, and obstetric background.
DESIGN
Analysis of prospective data from midwives and their clients.
SETTING
54 midwifery practices in the province of Gelderland, Netherlands.
SUBJECTS
97 midwives and 1836 women with low risk pregnancies who had planned to give birth at home or in hospital.
MAIN OUTCOME MEASURE
Perinatal outcome index based on "maximal result with minimal intervention" and incorporating 22 items on childbirth, 9 on the condition of the newborn, and 5 on the mother after the birth.
RESULTS
There was no relation between the planned place of birth and perinatal outcome in primiparous women when controlling for a favourable or less favourable background. In multiparous women, perinatal outcome was significantly better for planned home births than for planned hospital births, with or without control for background variables.
CONCLUSIONS
The outcome of planned home births is at least as good as that of planned hospital births in women at low risk receiving midwifery care in the Netherlands.
目的
在控制产次以及社会、医学和产科背景因素后，研究低风险妊娠女性预期的分娩地点（家中或医院）与围产期结局之间的关系。
设计
对助产士及其服务对象的前瞻性数据进行分析。
地点
荷兰海尔德兰省的54家助产机构。
研究对象
97名助产士和1836名计划在家中或医院分娩的低风险妊娠女性。
主要观察指标
基于“以最小干预获得最大效果”的围产期结局指数，包括22项分娩相关项目、9项新生儿状况项目以及5项产后母亲状况项目。
结果
在控制有利或不利背景因素后，初产妇计划的分娩地点与围产期结局之间没有关联。在经产妇中，无论是否控制背景变量，计划在家中分娩的围产期结局显著优于计划在医院分娩的。
结论
在荷兰，接受助产护理的低风险女性中，计划在家中分娩的结局至少与计划在医院分娩的结局一样好。
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