TY - JOUR
T1 - Maternal and neonatal outcomes following waterbirth
T2 - a cohort study of 17 530 waterbirths and 17 530 propensity score-matched land births
AU - Bovbjerg, M. L.
AU - Cheyney, M.
AU - Caughey, A. B.
N1 - Funding Information:
This project was funded by the U.S. Department of Health & Human Services, NICHD/NIH R03HD096094. In addition, Dr Bovbjerg’s time was partly funded by the J. William Fulbright Scholarship Board and the Fulbright Commission in Ireland. We thank Bruce Ackerman, Jennifer Brown, Courtney Everson and the other volunteers at the former MANA Division of Research, without whose efforts these data could not have been collected.
Funding Information:
This project was funded by the U.S. Department of Health & Human Services, NICHD/NIH R03HD096094. In addition, Dr Bovbjerg’s time was partly funded by the J. William Fulbright Scholarship Board and the Fulbright Commission in Ireland.
Publisher Copyright:
© 2021 John Wiley & Sons Ltd.
PY - 2022/5
Y1 - 2022/5
N2 - Objective: Investigate maternal and neonatal outcomes following waterbirth. Design: Retrospective cohort study, with propensity score matching to address confounding. Setting: Community births, United States. Sample: Medical records-based registry data from low-risk births were used to create waterbirth and land birth groups (n = 17 530 each), propensity score-matched on >80 demographic and pregnancy risk covariables. Methods: Logistic regression models compared outcomes between the matched waterbirth and land birth groups. Main outcome measures: Maternal: immediate postpartum transfer to a hospital, any genital tract trauma, severe (3rd/4th degree) trauma, haemorrhage >1000 mL, diagnosed haemorrhage regardless of estimated blood loss, uterine infection, uterine infection requiring hospitalisation, any hospitalisation in the first 6 weeks. Neonatal: umbilical cord avulsion; immediate neonatal transfer to a hospital; respiratory distress syndrome; any hospitalisation, neonatal intensive care unit (NICU) admission, or neonatal infection in the first 6 weeks; and neonatal death. Results: Waterbirth was associated with improved or no difference in outcomes for most measures, including neonatal death (adjusted odds ratio [aOR] 0.56, 95% CI 0.31–1.0), and maternal or neonatal hospitalisation in the first 6 weeks (aOR 0.87, 95% CI 0.81–0.92 and aOR 0.95, 95% CI 0.90–0.99, respectively). Increased morbidity in the waterbirth group was observed for two outcomes only: uterine infection (aOR 1.25, 95% CI 1.05–1.48) (but not hospitalisation for infection) and umbilical cord avulsion (aOR 1.57, 95% CI 1.37–1.82). Our results are concordant with other studies: waterbirth is neither as harmful as some current guidelines suggest, nor as benign as some proponents claim. Tweetable abstract: New study demonstrates #waterbirth is neither as harmful as some current guidelines suggest, nor as benign as some proponents claim. @TheUpliftLab @BovbjergMarit @31415926abc @NICHD_NIH.
AB - Objective: Investigate maternal and neonatal outcomes following waterbirth. Design: Retrospective cohort study, with propensity score matching to address confounding. Setting: Community births, United States. Sample: Medical records-based registry data from low-risk births were used to create waterbirth and land birth groups (n = 17 530 each), propensity score-matched on >80 demographic and pregnancy risk covariables. Methods: Logistic regression models compared outcomes between the matched waterbirth and land birth groups. Main outcome measures: Maternal: immediate postpartum transfer to a hospital, any genital tract trauma, severe (3rd/4th degree) trauma, haemorrhage >1000 mL, diagnosed haemorrhage regardless of estimated blood loss, uterine infection, uterine infection requiring hospitalisation, any hospitalisation in the first 6 weeks. Neonatal: umbilical cord avulsion; immediate neonatal transfer to a hospital; respiratory distress syndrome; any hospitalisation, neonatal intensive care unit (NICU) admission, or neonatal infection in the first 6 weeks; and neonatal death. Results: Waterbirth was associated with improved or no difference in outcomes for most measures, including neonatal death (adjusted odds ratio [aOR] 0.56, 95% CI 0.31–1.0), and maternal or neonatal hospitalisation in the first 6 weeks (aOR 0.87, 95% CI 0.81–0.92 and aOR 0.95, 95% CI 0.90–0.99, respectively). Increased morbidity in the waterbirth group was observed for two outcomes only: uterine infection (aOR 1.25, 95% CI 1.05–1.48) (but not hospitalisation for infection) and umbilical cord avulsion (aOR 1.57, 95% CI 1.37–1.82). Our results are concordant with other studies: waterbirth is neither as harmful as some current guidelines suggest, nor as benign as some proponents claim. Tweetable abstract: New study demonstrates #waterbirth is neither as harmful as some current guidelines suggest, nor as benign as some proponents claim. @TheUpliftLab @BovbjergMarit @31415926abc @NICHD_NIH.
KW - Natural childbirth
KW - propensity score
KW - water birth
KW - waterbirth
UR - http://www.scopus.com/inward/record.url?scp=85120375944&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85120375944&partnerID=8YFLogxK
U2 - 10.1111/1471-0528.17009
DO - 10.1111/1471-0528.17009
M3 - Article
C2 - 34773367
AN - SCOPUS:85120375944
VL - 129
SP - 950
EP - 958
JO - BJOG: An International Journal of Obstetrics and Gynaecology
JF - BJOG: An International Journal of Obstetrics and Gynaecology
SN - 1470-0328
IS - 6
ER -