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Maternal and Neonatal Outcomes in Hospital-Based Deliveries With Water Immersion
OBJECTIVE: To compare neonatal intensive care unit (NICU) or special care nursery admission for deliveries with water immersion compared with deliveries in the matched control group without water immersion. Secondary outcomes included adverse neonatal diagnoses, maternal infections, and perineal lac...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7505143/ https://www.ncbi.nlm.nih.gov/pubmed/32925614 http://dx.doi.org/10.1097/AOG.0000000000003956 |
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author | Sidebottom, Abbey C. Vacquier, Marc Simon, Kathrine Wunderlich, Whitney Fontaine, Patricia Dahlgren-Roemmich, Dawn Steinbring, Shannon Hyer, Barbara Saul, Lisa |
author_facet | Sidebottom, Abbey C. Vacquier, Marc Simon, Kathrine Wunderlich, Whitney Fontaine, Patricia Dahlgren-Roemmich, Dawn Steinbring, Shannon Hyer, Barbara Saul, Lisa |
author_sort | Sidebottom, Abbey C. |
collection | PubMed |
description | OBJECTIVE: To compare neonatal intensive care unit (NICU) or special care nursery admission for deliveries with water immersion compared with deliveries in the matched control group without water immersion. Secondary outcomes included adverse neonatal diagnoses, maternal infections, and perineal lacerations. METHODS: We conducted a retrospective study using electronic health record data (2014–2018) from two health systems (eight hospitals), with similar clinical eligibility, associated with low risks of intrapartum complications, and implementation policies for waterbirth. The water immersion group included women intending waterbirth. Water immersion was recorded prospectively during delivery. The comparison population were women who met the clinical eligibility criteria for waterbirth but did not experience water immersion during labor. Comparison cases were matched (1:1) using propensity scores. Outcomes were compared using Fischer's exact tests and logistic regression with stratification by stage of water immersion. RESULTS: Of the 583 women with water immersion, 34.1% (199) experienced first-stage water immersion only, 65.9% (384) experienced second-stage immersion, of whom 12.0% (70) exited during second stage, and 53.9% (314) completed delivery in the water. Neonatal intensive care unit or special care nursery admissions were lower for second-stage water immersion deliveries than deliveries in the control group (odds ratio [OR] 0.3, 95% CI 0.2–0.7). Lacerations were lower in the second-stage immersion group (OR 0.5, 95% CI 0.4–0.7). Neonatal intensive care unit or special care nursery admissions and lacerations were not different between the first-stage immersion group and their matched comparisons. Cord avulsions occurred for 0.8% of second-stage water immersion deliveries compared with none in the control groups. Five-minute Apgar score (less than 7), maternal infections, and other adverse outcomes were not significantly different between either the first- or second-stage water immersion groups and their control group. CONCLUSION: Hospital-based deliveries with second-stage water immersion had lower risk of NICU or special care nursery admission and perineal lacerations than matched deliveries in the control group without water immersion. |
format | Online Article Text |
id | pubmed-7505143 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-75051432020-09-24 Maternal and Neonatal Outcomes in Hospital-Based Deliveries With Water Immersion Sidebottom, Abbey C. Vacquier, Marc Simon, Kathrine Wunderlich, Whitney Fontaine, Patricia Dahlgren-Roemmich, Dawn Steinbring, Shannon Hyer, Barbara Saul, Lisa Obstet Gynecol Contents OBJECTIVE: To compare neonatal intensive care unit (NICU) or special care nursery admission for deliveries with water immersion compared with deliveries in the matched control group without water immersion. Secondary outcomes included adverse neonatal diagnoses, maternal infections, and perineal lacerations. METHODS: We conducted a retrospective study using electronic health record data (2014–2018) from two health systems (eight hospitals), with similar clinical eligibility, associated with low risks of intrapartum complications, and implementation policies for waterbirth. The water immersion group included women intending waterbirth. Water immersion was recorded prospectively during delivery. The comparison population were women who met the clinical eligibility criteria for waterbirth but did not experience water immersion during labor. Comparison cases were matched (1:1) using propensity scores. Outcomes were compared using Fischer's exact tests and logistic regression with stratification by stage of water immersion. RESULTS: Of the 583 women with water immersion, 34.1% (199) experienced first-stage water immersion only, 65.9% (384) experienced second-stage immersion, of whom 12.0% (70) exited during second stage, and 53.9% (314) completed delivery in the water. Neonatal intensive care unit or special care nursery admissions were lower for second-stage water immersion deliveries than deliveries in the control group (odds ratio [OR] 0.3, 95% CI 0.2–0.7). Lacerations were lower in the second-stage immersion group (OR 0.5, 95% CI 0.4–0.7). Neonatal intensive care unit or special care nursery admissions and lacerations were not different between the first-stage immersion group and their matched comparisons. Cord avulsions occurred for 0.8% of second-stage water immersion deliveries compared with none in the control groups. Five-minute Apgar score (less than 7), maternal infections, and other adverse outcomes were not significantly different between either the first- or second-stage water immersion groups and their control group. CONCLUSION: Hospital-based deliveries with second-stage water immersion had lower risk of NICU or special care nursery admission and perineal lacerations than matched deliveries in the control group without water immersion. Lippincott Williams & Wilkins 2020-10 2020-09-08 /pmc/articles/PMC7505143/ /pubmed/32925614 http://dx.doi.org/10.1097/AOG.0000000000003956 Text en © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Contents Sidebottom, Abbey C. Vacquier, Marc Simon, Kathrine Wunderlich, Whitney Fontaine, Patricia Dahlgren-Roemmich, Dawn Steinbring, Shannon Hyer, Barbara Saul, Lisa Maternal and Neonatal Outcomes in Hospital-Based Deliveries With Water Immersion |
title | Maternal and Neonatal Outcomes in Hospital-Based Deliveries With Water Immersion |
title_full | Maternal and Neonatal Outcomes in Hospital-Based Deliveries With Water Immersion |
title_fullStr | Maternal and Neonatal Outcomes in Hospital-Based Deliveries With Water Immersion |
title_full_unstemmed | Maternal and Neonatal Outcomes in Hospital-Based Deliveries With Water Immersion |
title_short | Maternal and Neonatal Outcomes in Hospital-Based Deliveries With Water Immersion |
title_sort | maternal and neonatal outcomes in hospital-based deliveries with water immersion |
topic | Contents |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7505143/ https://www.ncbi.nlm.nih.gov/pubmed/32925614 http://dx.doi.org/10.1097/AOG.0000000000003956 |
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