Research conducted by Joseph R. Wax, MD, and colleagues, from the department of obstetrics and gynecology at Maine Medical Center in Portland, shows that the overall newborn death rate was almost twice as high in planned home vs. planned hospital births, and was almost tripled among those newborns in planned home births without any congenital abnormalities.そもそもの新生児死亡率は小さいが、家庭と病院の差は歴然としたものがある。
PortlandのMaine Medicat Centerの産婦人科のJoseph R. Wax MDの研究チームによって行われた研究で、計画家庭出産の新生児死亡率は計画病院出産の2倍、先天異常がない場合の新生児死亡率は計画病院出産の3倍であることがわかった。
Although rare, newborn deaths occurred in 0.2% of the total planned home births included in the analysis, compared with 0.09% of the total planned hospital births. Among infants born without any birth defects, the rates were 0.15% vs. 0.04%, respectively.
研究対象の出産では、計画家庭出産の新生児死亡率は0.2%であるの対して、計画病院出産は0.09%だった。先天異常がない場合は0.15% 対 0.04%だった。
Overall, compared with hospital deliveries, planned home births were associated with reduced medical intervention for the mothers and in reduced prematurity and low birth weight, the researchers reported. However, planned home births were also linked to neonatal deaths attributed to respiratory distress and failed resuscitation.
病院での出産と比較すると、計画家庭出産は、医療介入・未熟児・低出生体重の率が小さかった。しかし、計画家庭出産では、呼吸窮迫症候群および蘇生失敗による死亡率が高かった。
[Katrina Woznicki (Reviewed by Laura J. Martin, MD) : "Home Births Linked to Higher Newborn Death Rate --Planned Home Births Also Associated With Reduced Medical Intervention for Moms (2010/07/02) on WebMD Health News ]
この新生児死亡率の差が、逆に、家庭出産が良いもののように見せかけてしまう。
The findings, published online by the American Journal of Obstetrics & Gynecology, are based on an analysis of international data. The data included maternal and newborn outcomes for planned and home births recorded in national registries and birth certificates in industrialized, Western countries. Wax and his team included data for a total of 342,056 planned home births and 207,511 planned hospital deliveries. They looked at both the health of the infants and of the mothers.一見、家庭出産が良いようにも見えるが、それは見せかけのもの：“Our findings raise the question of a link between the increased neonatal mortality among planned home births and the decreased obstetric intervention in this group,” Wax and colleagues write. “Women choosing home birth, particularly low-risk individuals who had given birth previously, are in large part successful in achieving their goal of delivering with less morbidity and medical intervention than experienced during hospital-based childbirth. Of significant concern, these apparent benefits are associated with a doubling of the neonatal mortality rate overall and a near tripling among infants born without congenital defects.”
American Journal of Obstetrics & Gynecologyオンライン版に掲載された研究結果は、国際的なデータ解析に基づいている。このデータは西側先進国の政府登録および出生証明に記録された計画家庭出産における母体および新生児のデータが含まれている。Joseph R. Wax MDの研究チームは342,056の計画家庭出産と207,511計画病院出産を分析した。彼らは新生児および母親の健康について着目した。
They found that there was no overall difference in newborn assisted ventilation between home and hospital deliveries. Women who participated in planned home births had lower obstetric risk factors overall, including lower rates of obesity, previous cesarean sections, or previous pregnancy complications.
彼らは家庭と病院で人口呼吸器について差異はなかった。研究対象となった、家庭出産の女性は、肥満度や帝王切開の経験や前回出産時の合併症などの出産リスクファクターが小さかった。
Researchers also reported that women who participated in planned home births had:
研究者たちはまた、計画家庭出産した女性について以下の結果を得ている：
- Less use of epidurals and episiotomies
- Fewer infections and perineal or vaginal lacerations
- Less hemorrhaging or incidences of retained placentas
- Fewer operative deliveries, such as cesareans
- 硬膜外麻酔や会陰切開をすることが少ない
- 感染症や会陰部や膣の裂傷が少ない
- 胎盤での出血等が少ない
- 帝王切開のような手術による出産が少ない
[Katrina Woznicki (Reviewed by Laura J. Martin, MD) : "Home Births Linked to Higher Newborn Death Rate --Planned Home Births Also Associated With Reduced Medical Intervention for Moms (2010/07/02) on WebMD Health News ]
「我々の研究結果は、計画家庭出産における新生児死亡率の増大と、このグループにおける産科介入の減少の関連に疑問を投げかける。家庭出産を選択した女性たち、特に既に出産を経験したリスクの低い女性たちは、病院出産よりも、罹患率および病院介入の低い率を実現している。重大な懸念は、この見かけの良い点は、新生児死亡率が2倍、先天異常がない場合の新生児死亡率が3倍になっていることと関連していることである。
[Katrina Woznicki (Reviewed by Laura J. Martin, MD) : "Home Births Linked to Higher Newborn Death Rate --Planned Home Births Also Associated With Reduced Medical Intervention for Moms (2010/07/02) on WebMD Health News ]
