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dc.contributor.authorScarf, Vanessa L
dc.contributor.authorRossiter, Chris
dc.contributor.authorVedam, Saraswathi
dc.contributor.authorDahlen, Hannah G
dc.contributor.authorEllwood, David
dc.contributor.authorForster, Della
dc.contributor.authorFoureur, Maralyn J
dc.contributor.authorMcLachlan, Helen
dc.contributor.authorOats, Jeremy
dc.contributor.authorSibbritt, David
dc.contributor.authorThornton, Charlene
dc.contributor.authorHomer, Caroline SE
dc.date.accessioned2019-07-04T12:39:42Z
dc.date.available2019-07-04T12:39:42Z
dc.date.issued2018
dc.identifier.issn0266-6138
dc.identifier.doi10.1016/j.midw.2018.03.024
dc.identifier.urihttp://hdl.handle.net/10072/381345
dc.description.abstractBackground: The comparative safety of different birth settings is widely debated. Comparing research across high-income countries is complex, given differences in maternity service provision, data discrepancies, and varying research techniques and quality. Studies of births planned at home or in birth centres have reported both better and poorer outcomes than planned hospital births. Previous systematic reviews have focused on outcomes from either birth centres or home births, with inconsistent attention to quality appraisal. Few have attempted to synthesise findings. Objective: To compare maternal and perinatal outcomes from different places of birth via a systematic review of high-quality research, and meta-analysis of appropriate data (Prospero registration CRD42016042291). Design: Reviewers searched CINAHL, Embase, Maternity and Infant Care, Medline and PsycINFO databases to identify studies comparing selected outcomes by place of birth among women with low-risk pregnancies in high-income countries. They critically appraised identified studies using an instrument specific to birth place research and then combined outcome data via meta-analysis, using RevMan software. Findings: Twenty-eight articles met inclusion criteria, yielding comparative data on perinatal mortality, mode of birth, maternal morbidity and/or NICU admissions. Meta-analysis indicated that women planning hospital births had statistically significantly lower odds of normal vaginal birth than in other planned settings. Women experienced severe perineal trauma or haemorrhage at a lower rate in planned home births than in obstetric units. There were no statistically significant differences in infant mortality by planned place of birth, although most studies had limited statistical power to detect differences for rare outcomes. Differences in location, context, quality and design of identified studies render results subject to variation. Conclusions and implications for practice: High-quality evidence about low-risk pregnancies indicates that place of birth had no statistically significant impact on infant mortality. The lower odds of maternal morbidity and obstetric intervention support the expansion of birth centre and home birth options for women with low-risk pregnancies.
dc.description.peerreviewedYes
dc.description.sponsorshipGold Coast Hospital and Health Service
dc.description.sponsorshipGold Coast Hospital and Health Service
dc.languageEnglish
dc.publisherElsevier
dc.publisher.placeUnited Kingdom
dc.relation.ispartofpagefrom240
dc.relation.ispartofpageto255
dc.relation.ispartofjournalMidwifery
dc.relation.ispartofvolume62
dc.relation.urihttp://purl.org/au-research/grants/NHMRC/GNT1081026
dc.relation.urihttp://purl.org/au-research/grants/NHMRC/APP1067363
dc.relation.urihttp://purl.org/au-research/grants/NHMRC/APP1029613
dc.relation.urihttp://purl.org/au-research/grants/NHMRC/APP1116640
dc.relation.grantIDGNT1081026
dc.relation.grantIDAPP1067363
dc.relation.grantIDAPP1029613
dc.relation.grantIDAPP1116640
dc.relation.fundersNHMRC
dc.subject.fieldofresearchNursing
dc.subject.fieldofresearchReproductive medicine not elsewhere classified
dc.subject.fieldofresearchHealth services and systems
dc.subject.fieldofresearchPublic health
dc.subject.fieldofresearchReproductive medicine
dc.subject.fieldofresearchMidwifery
dc.subject.fieldofresearchcode4205
dc.subject.fieldofresearchcode321599
dc.subject.fieldofresearchcode4203
dc.subject.fieldofresearchcode4206
dc.subject.fieldofresearchcode3215
dc.subject.fieldofresearchcode4204
dc.titleMaternal and perinatal outcomes by planned place of birth among women with low-risk pregnancies in high-income countries: A systematic review and meta-analysis
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
dcterms.licensehttp://creativecommons.org/licenses/by-nc-nd/4.0/
dc.description.versionVersion of Record (VoR)
gro.rights.copyright© 2018 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.
gro.hasfulltextFull Text
gro.griffith.authorEllwood, David A.


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