Maternal and neonatal outcomes in birth centers versus hospitals among low-risk pregnancies in Japan: A retrospective cohort study
Maternal and neonatal outcomes in birth centers versus hospitals among low-risk pregnancies in Japan: A retrospective cohort study
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日本低风险妊娠中分娩中心与医院的孕产妇和新生儿结局：一项回顾性队列研究
DOI：
10.1111/jjns.12171
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发表时间：
2018
影响因子：
1.7
通讯作者：
Hiromi Eto
中科院分区：
文献类型：
--
作者：
Yaeko Kataoka;Yuko Masuzawa;Chiho Kato;Hiromi Eto
目的为了让低风险孕妇根据风险和益处做出分娩决定，她们需要从出生中心获得分娩结果的证据。本研究的目的是描述和比较在日本出生中心和医院分娩的低风险妇女的母婴结局。方法研究对象为9588名在东京19个分娩中心和两家医院分娩的单胎阴道分娩妇女。这些数据是从他们的医疗记录中收集的，包括他们的年龄、产次、分娩方式、母亲分娩时的体位、产程、产中失血、会阴创伤、出生时孕周、出生体重、阿普加评分和死产。结果助产士主导分娩中心的产妇L总出血量高于医院，但会撕裂伤的发生率低于医院。与医院相比，助产士主导的分娩中心出生的婴儿阿普加评分为<；7的婴儿较少。结论本研究首次比较了分娩中心和医院的重要孕产妇和新生儿结局。使用匹配的基线特征的额外研究可以澄清母亲和新生儿结局的比较。
AimIn order for low‐risk pregnant women to base birth decisions on the risks and benefits, they need evidence of birth outcomes from birth centers. The purpose of this study was to describe and compare the maternal and neonatal outcomes of low‐risk women who gave birth in birth centers and hospitals in Japan.MethodsThe participants were 9588 women who had a singleton vaginal birth at 19 birth centers and two hospitals in Tokyo. The data were collected from their medical records, including their age, parity, mode of delivery, maternal position at delivery, duration of labor, intrapartum blood loss, perineal trauma, gestational weeks at birth, birth weight, Apgar score, and stillbirths. For the comparison of birth centers with hospitals, adjusted odds ratios for the birth outcomes were estimated by using a logistic regression analysis.ResultsThe number of women who had a total blood loss of >1 L was higher in the midwife‐led birth centers than in the hospitals but the incidence of perineal lacerations was lower. There were fewer infants who were born at the midwife‐led birth centers with Apgar scores of <7, compared to the hospitals.ConclusionThis study was the first to compare important maternal and neonatal outcomes of birth centers and hospitals. Additional research, using matched baseline characteristics, could clarify the comparisons for maternal and neonatal outcomes.