Document 0618
 DOCN  M9460618
 TI    Outcome of unattended out-of-hospital births in Harlem.
 DT    9404
 AU    Bateman DA; O'Bryan L; Nicholas SW; Heagarty MC; Department of
       Pediatrics, Harlem Hospital Center, Columbia; University, College of
       Physicians and Surgeons, New York, NY.
 SO    Arch Pediatr Adolesc Med. 1994 Feb;148(2):147-52. Unique Identifier :
       AIDSLINE MED/94163309
 AB    OBJECTIVE: To determine the maternal risk factors and infant outcome for
       unattended out-of-hospital deliveries brought to an inner-city public
       hospital. METHODS: We compared 59 infants born alive out of hospital
       during 1989 with 151 randomly selected in-hospital live births, all with
       birth weight greater than 500 g. RESULTS: History of cocaine use during
       pregnancy (odds ratio [OR], 4.20; 95% confidence interval [CI], 1.68 to
       10.5) and lack of Medicaid or other health insurance (OR, 2.15; 95% CI,
       1.04 to 4.45) were independently associated with out-of-hospital
       delivery. Out-of-hospital delivery was associated with hypothermia
       (defined as admission axillary temperature < 35 degrees C; OR, 20.8; 95%
       CI, 4.81 to 89.9) and with hypoglycemia (defined as admission glucose
       reagent strip reading < 2.2 mmol/L [< 40 mg/dL]; OR, 4.41; 95% CI, 1.29
       to 15.1) in separate analyses controlling for birth weight and other
       risk factors. Polycythemia (venous or arterial hematocrit > 0.65 at age
       > or = 6 hours) occurred in 14% (eight of 59) of out-of-hospital births.
       The increased neonatal mortality rate for infants born out of hospital
       (20.3 vs 7.3 per 1000 live births; OR, 2.82; 95% CI, 1.23 to 6.47) was
       due to an excess of infants weighing 500 to 999 g. CONCLUSIONS:
       Unattended out-of-hospital births result in increased neonatal morbidity
       that may be partly preventable by simple interventions used routinely at
       inhospital deliveries.
 DE    Adult  Comparative Study  Female  Home Childbirth/*ADVERSE EFFECTS
       *Hospitalization  Human  HIV Infections/EPIDEMIOLOGY  Infant Mortality
       Infant, Low Birth Weight  Infant, Newborn  Insurance, Health  *Labor
       Male  Medicaid  New York City/EPIDEMIOLOGY  Pregnancy  Pregnancy
       Complications/EPIDEMIOLOGY  Risk Factors  Substance Abuse/EPIDEMIOLOGY
       United States/EPIDEMIOLOGY  CLINICAL TRIAL  JOURNAL ARTICLE  RANDOMIZED
       CONTROLLED TRIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).