Planned Home Compared With Planned Hospital Births in the Netherlands: Intrapartum and Early Neonatal Death in Low-Risk Pregnancies

摘要

To the Editor: We congratulate van der Kooy et al on their report comparing delivery-related perinatal mortality between planned home and planned hospital births in the Netherlands.1 The study is an important and timely contribution to the literature on this topic. The results confirm the low absolute delivery-related perinatal mortality rate associated with planned home birth compared with planned hospital birth under the care of licensed midwives. However, the methods lead us to suspect that, in reality, the rate is likely to be higher than presented. Retrospectively excluding women prospectively planning home or hospital birth under the care of a midwife at labor onset reduced the obstetric risk of the entire cohort, thereby reducing the risk of delivery-related perinatal death. The subgroup excluded from the perfect guideline analysis included Women with risk factors not necessarily riredict-able during the prenatal or intrapartum course but requiring transfer to hospital