To assess the risk of perinatal death in planned home births in Australia Design : Comparison of data on planned home births during 1985-90, notified to Homebirth Australia, with national data on perinatal deaths and outcomes of home births internationally.
50 perinatal deaths occurred in 7002 planned home births in Australia during 1985-90 : 7.1 per 1000 (95% confidence interval 5.2 to 9.1) according to Australian definitions and 6.4 per 1000 (4.6 to 8.3) according to World Health Organisation definitions.
The perinatal death rate in infants weighing more than 2500 g was higher than the national average (5.7 versus 3.6 per 1000 : relative risk 1.6 ; 1.1 to 2.4) as were intrapartum deaths not due to malformations or immaturity (2.7 versus 0.9 per 1000 : 3.0 ; 1.9 to 4.8).
More than half (52%) of the deaths were associated with intrapartum asphyxia Conclusions : Australian home births carried a high death rate compared with both all Australian births and home births elsewhere.
The two largest contributors to the excess mortality were underestimation of the risks associated with post-term birth, twin pregnancy and breech presentation, and a lack of response to fetal distress.
Mots-clés Pascal : Mortalité, Nouveau né, Homme, Australie, Océanie, Maison individuelle, Accouchement, Epidémiologie, Facteur risque, Etiologie, Complication, Accouchement pathologie, Exploration, Gestation pathologie
Mots-clés Pascal anglais : Mortality, Newborn, Human, Australia, Oceania, One family house, Delivery, Epidemiology, Risk factor, Etiology, Complication, Delivery disorders, Exploration, Pregnancy disorders
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0404371
Code Inist : 002B20G01. Création : 25/01/1999.